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 $77.62 Median $3,981.07 Typical High $10,715.19 | Facility | None | $77.62 | $3,981.07 | $10,715.19 |
Aetna Setting Professional Modifier None (both parts) Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | None (both parts) | $77.62 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $29.51 Median $29.51 Typical High $29.51 | Professional | 26 · Professional part | $29.51 | $29.51 | $29.51 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | TC · Technical part | $47.86 | $47.86 | $47.86 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $52.48 Median $74.13 Typical High $89.13 | Professional | None (both parts) | $52.48 | $74.13 | $89.13 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $24.55 Median $30.20 Typical High $46.77 | Professional | 26 · Professional part | $24.55 | $30.20 | $46.77 |
Anthem BCBS Setting Professional Modifier TC · Technical part Typical Low $30.90 Median $41.69 Typical High $52.48 | Professional | TC · Technical part | $30.90 | $41.69 | $52.48 |
Select Health Setting Facility Modifier None Typical Low $33.11 Median $77.62 Typical High $4,265.80 | Facility | None | $33.11 | $77.62 | $4,265.80 |
Select Health Setting Professional Modifier None (both parts) Typical Low $28.18 Median $77.62 Typical High $77.62 | Professional | None (both parts) | $28.18 | $77.62 | $77.62 |
United Setting Professional Modifier None (both parts) Typical Low $70.79 Median $87.10 Typical High $125.89 | Professional | None (both parts) | $70.79 | $87.10 | $125.89 |
United Setting Professional Modifier 26 · Professional part Typical Low $27.54 Median $33.11 Typical High $52.48 | Professional | 26 · Professional part | $27.54 | $33.11 | $52.48 |
United Setting Professional Modifier TC · Technical part Typical Low $42.66 Median $54.95 Typical High $75.86 | Professional | TC · Technical part | $42.66 | $54.95 | $75.86 |
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 $38.90 Median $38.90 Typical High $38.90 | Professional | 52 · Reduced service | $38.90 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $15.49 Typical High $15.49 | Professional | 53 · Discontinued | $15.49 | $15.49 | $15.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | 54 · Surgery only | $57.54 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $11.75 Typical High $11.75 | Professional | 55 · Aftercare only | $11.75 | $11.75 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $7.76 Typical High $7.76 | Professional | 56 · Pre-op care only | $7.76 | $7.76 | $7.76 |
Where Nevada 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.
Nevada· 26th of 51
$77.62
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.