How much rates vary
Facilitymedian $339 · 10th to 90th $93 to $6,310Professionalmedian $85 · 10th to 90th $69 to $550
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $1,698.24 Median $4,897.79 Typical High $7,762.47 | Facility | None | $1,698.24 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None (both parts) Typical Low $46.77 Median $69.18 Typical High $93.33 | Professional | None (both parts) | $46.77 | $69.18 | $93.33 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $18.20 Median $26.92 Typical High $35.48 | Professional | 26 · Professional part | $18.20 | $26.92 | $35.48 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $28.84 Median $42.66 Typical High $56.23 | Professional | TC · Technical part | $28.84 | $42.66 | $56.23 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $67.61 Median $74.13 Typical High $134.90 | Professional | None (both parts) | $67.61 | $74.13 | $134.90 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $38.90 Median $45.71 Typical High $87.10 | Professional | 26 · Professional part | $38.90 | $45.71 | $87.10 |
Anthem BCBS Setting Professional Modifier TC · Technical part Typical Low $26.30 Median $29.51 Typical High $52.48 | Professional | TC · Technical part | $26.30 | $29.51 | $52.48 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $100.00 Typical High $117.49 | Facility | None | $56.23 | $100.00 | $117.49 |
Cigna Setting Professional Modifier None (both parts) Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None (both parts) | $125.89 | $125.89 | $125.89 |
Medica Setting Facility Modifier None Typical Low $74.13 Median $190.55 Typical High $338.84 | Facility | None | $74.13 | $190.55 | $338.84 |
Medica Setting Professional Modifier None (both parts) Typical Low $95.50 Median $512.86 Typical High $549.54 | Professional | None (both parts) | $95.50 | $512.86 | $549.54 |
Medica Setting Professional Modifier 26 · Professional part Typical Low $54.95 Median $218.78 Typical High $218.78 | Professional | 26 · Professional part | $54.95 | $218.78 | $218.78 |
Medica Setting Professional Modifier TC · Technical part Typical Low $42.66 Median $199.53 Typical High $331.13 | Professional | TC · Technical part | $42.66 | $199.53 | $331.13 |
United Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $123.03 | Facility | None | $117.49 | $117.49 | $123.03 |
United Setting Professional Modifier None (both parts) Typical Low $74.13 Median $128.82 Typical High $199.53 | Professional | None (both parts) | $74.13 | $128.82 | $199.53 |
United Setting Professional Modifier 26 · Professional part Typical Low $30.20 Median $75.86 Typical High $100.00 | Professional | 26 · Professional part | $30.20 | $75.86 | $100.00 |
United Setting Professional Modifier TC · Technical part Typical Low $38.02 Median $52.48 Typical High $123.03 | Professional | TC · Technical part | $38.02 | $52.48 | $123.03 |
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 $23.44 Median $34.67 Typical High $45.71 | Professional | 52 · Reduced service | $23.44 | $34.67 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $13.80 Typical High $18.62 | Professional | 53 · Discontinued | $9.33 | $13.80 | $18.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $52.48 Typical High $69.18 | Professional | 54 · Surgery only | $35.48 | $52.48 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $10.47 Typical High $13.80 | Professional | 55 · Aftercare only | $7.08 | $10.47 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $6.92 Typical High $9.33 | Professional | 56 · Pre-op care only | $4.68 | $6.92 | $9.33 |
Where Missouri 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.
Missouri· 18th of 51
$87.10
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.