How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $1,949.84 Median $5,495.41 Typical High $9,549.93 | Facility | None | $1,949.84 | $5,495.41 | $9,549.93 |
Aetna Setting Professional Modifier None (both parts) Typical Low $63.10 Median $63.10 Typical High $69.18 | Professional | None (both parts) | $63.10 | $63.10 | $69.18 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $25.12 Median $25.12 Typical High $26.92 | Professional | 26 · Professional part | $25.12 | $25.12 | $26.92 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $38.02 Median $38.02 Typical High $42.66 | Professional | TC · Technical part | $38.02 | $38.02 | $42.66 |
BCBS Kansas Setting Professional Modifier None (both parts) Typical Low $34.67 Median $54.95 Typical High $89.13 | Professional | None (both parts) | $34.67 | $54.95 | $89.13 |
Cigna Setting Facility Modifier None Typical Low $38.02 Median $91.20 Typical High $123.03 | Facility | None | $38.02 | $91.20 | $123.03 |
Medica Setting Facility Modifier None Typical Low $41.69 Median $69.18 Typical High $190.55 | Facility | None | $41.69 | $69.18 | $190.55 |
Medica Setting Professional Modifier None (both parts) Typical Low $85.11 Median $123.03 Typical High $549.54 | Professional | None (both parts) | $85.11 | $123.03 | $549.54 |
Medica Setting Professional Modifier 26 · Professional part Typical Low $52.48 Median $74.13 Typical High $218.78 | Professional | 26 · Professional part | $52.48 | $74.13 | $218.78 |
Medica Setting Professional Modifier TC · Technical part Typical Low $34.67 Median $52.48 Typical High $331.13 | Professional | TC · Technical part | $34.67 | $52.48 | $331.13 |
United Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $69.18 | Facility | None | $43.65 | $43.65 | $69.18 |
United Setting Professional Modifier None (both parts) Typical Low $77.62 Median $107.15 Typical High $123.03 | Professional | None (both parts) | $77.62 | $107.15 | $123.03 |
United Setting Professional Modifier 26 · Professional part Typical Low $32.36 Median $64.57 Typical High $74.13 | Professional | 26 · Professional part | $32.36 | $64.57 | $74.13 |
United Setting Professional Modifier TC · Technical part Typical Low $33.11 Median $42.66 Typical High $52.48 | Professional | TC · Technical part | $33.11 | $42.66 | $52.48 |
5 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $31.62 Median $31.62 Typical High $34.67 | Professional | 52 · Reduced service | $31.62 | $31.62 | $34.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $12.59 Typical High $13.80 | Professional | 53 · Discontinued | $12.59 | $12.59 | $13.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $47.86 Median $47.86 Typical High $52.48 | Professional | 54 · Surgery only | $47.86 | $47.86 | $52.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $9.55 Typical High $10.47 | Professional | 55 · Aftercare only | $9.55 | $9.55 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $6.31 Typical High $6.92 | Professional | 56 · Pre-op care only | $6.31 | $6.31 | $6.92 |
Where Kansas sits
The same service costs 4.4 times more in Texas than in New York. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Kansas· 16th of 51
$89.13
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.