How much rates vary
Facilitymedian $76 · 10th to 90th $54 to $1,514Professionalmedian $47 · 10th to 90th $37 to $105
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 $53.70 Median $66.07 Typical High $794.33 | Facility | None | $53.70 | $66.07 | $794.33 |
Aetna Setting Professional Modifier None (both parts) Typical Low $53.70 Median $66.07 Typical High $69.18 | Professional | None (both parts) | $53.70 | $66.07 | $69.18 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $21.88 Median $26.92 Typical High $27.54 | Professional | 26 · Professional part | $21.88 | $26.92 | $27.54 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $32.36 Median $38.90 Typical High $41.69 | Professional | TC · Technical part | $32.36 | $38.90 | $41.69 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $37.15 Median $43.65 Typical High $60.26 | Professional | None (both parts) | $37.15 | $43.65 | $60.26 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $23.44 Median $27.54 Typical High $36.31 | Professional | 26 · Professional part | $23.44 | $27.54 | $36.31 |
Anthem BCBS Setting Professional Modifier TC · Technical part Typical Low $13.49 Median $15.85 Typical High $20.42 | Professional | TC · Technical part | $13.49 | $15.85 | $20.42 |
CareSource Setting Facility Modifier None Typical Low $75.86 Median $676.08 Typical High $1,698.24 | Facility | None | $75.86 | $676.08 | $1,698.24 |
CareSource Setting Professional Modifier None (both parts) Typical Low $91.20 Median $831.76 Typical High $1,621.81 | Professional | None (both parts) | $91.20 | $831.76 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
Cigna Setting Facility Modifier 26 · Professional part Typical Low $7.59 Median $35.48 Typical High $50.12 | Facility | 26 · Professional part | $7.59 | $35.48 | $50.12 |
Cigna Setting Facility Modifier TC · Technical part Typical Low $11.22 Median $52.48 Typical High $75.86 | Facility | TC · Technical part | $11.22 | $52.48 | $75.86 |
Cigna Setting Professional Modifier None (both parts) Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | None (both parts) | $354.81 | $354.81 | $354.81 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | 26 · Professional part | $134.90 | $134.90 | $134.90 |
Cigna Setting Professional Modifier TC · Technical part Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | TC · Technical part | $223.87 | $223.87 | $223.87 |
Molina Setting Professional Modifier None (both parts) Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | None (both parts) | $44.67 | $44.67 | $44.67 |
United Setting Professional Modifier None (both parts) Typical Low $72.44 Median $97.72 Typical High $134.90 | Professional | None (both parts) | $72.44 | $97.72 | $134.90 |
United Setting Professional Modifier 26 · Professional part Typical Low $29.51 Median $39.81 Typical High $52.48 | Professional | 26 · Professional part | $29.51 | $39.81 | $52.48 |
United Setting Professional Modifier TC · Technical part Typical Low $43.65 Median $57.54 Typical High $70.79 | Professional | TC · Technical part | $43.65 | $57.54 | $70.79 |
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 $26.92 Median $33.11 Typical High $34.67 | Professional | 52 · Reduced service | $26.92 | $33.11 | $34.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $13.18 Typical High $13.80 | Professional | 53 · Discontinued | $10.72 | $13.18 | $13.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $40.74 Median $48.98 Typical High $52.48 | Professional | 54 · Surgery only | $40.74 | $48.98 | $52.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $9.77 Typical High $10.47 | Professional | 55 · Aftercare only | $8.13 | $9.77 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $6.61 Typical High $6.92 | Professional | 56 · Pre-op care only | $5.37 | $6.61 | $6.92 |
Where Kentucky 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.
Kentucky· 49th of 51
$46.77
TX $174NY $39.81
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.