How much rates vary
Facilitymedian $76 · 10th to 90th $32 to $8,318Professionalmedian $59 · 10th to 90th $45 to $93
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 $83.18 Median $5,495.41 Typical High $14,125.38 | Facility | None | $83.18 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None (both parts) Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None (both parts) | $83.18 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $28.84 Median $28.84 Typical High $31.62 | Professional | 26 · Professional part | $28.84 | $28.84 | $31.62 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $51.29 Median $51.29 Typical High $53.70 | Professional | TC · Technical part | $51.29 | $51.29 | $53.70 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $46.77 Median $53.70 Typical High $67.61 | Professional | None (both parts) | $46.77 | $53.70 | $67.61 |
Cigna Setting Facility Modifier None Typical Low $43.65 Median $44.67 Typical High $97.72 | Facility | None | $43.65 | $44.67 | $97.72 |
Kaiser Permanente Setting Professional Modifier None Typical Low $72.44 Median $85.11 Typical High $107.15 | Professional | None | $72.44 | $85.11 | $107.15 |
Kaiser Permanente Setting Professional Modifier 26 · Professional part Typical Low $25.70 Median $30.20 Typical High $40.74 | Professional | 26 · Professional part | $25.70 | $30.20 | $40.74 |
Kaiser Permanente Setting Professional Modifier TC · Technical part Typical Low $44.67 Median $53.70 Typical High $67.61 | Professional | TC · Technical part | $44.67 | $53.70 | $67.61 |
Medcost Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
Sentara Setting Facility Modifier None Typical Low $29.51 Median $61.66 Typical High $208.93 | Facility | None | $29.51 | $61.66 | $208.93 |
Sentara Setting Professional Modifier None (both parts) Typical Low $20.42 Median $53.70 Typical High $104.71 | Professional | None (both parts) | $20.42 | $53.70 | $104.71 |
Sentara Setting Professional Modifier 26 · Professional part Typical Low $18.20 Median $30.90 Typical High $42.66 | Professional | 26 · Professional part | $18.20 | $30.90 | $42.66 |
Sentara Setting Professional Modifier TC · Technical part Typical Low $29.51 Median $52.48 Typical High $69.18 | Professional | TC · Technical part | $29.51 | $52.48 | $69.18 |
United Setting Facility Modifier None Typical Low $70.79 Median $77.62 Typical High $173.78 | Facility | None | $70.79 | $77.62 | $173.78 |
United Setting Professional Modifier None (both parts) Typical Low $63.10 Median $83.18 Typical High $141.25 | Professional | None (both parts) | $63.10 | $83.18 | $141.25 |
United Setting Professional Modifier 26 · Professional part Typical Low $23.44 Median $31.62 Typical High $52.48 | Professional | 26 · Professional part | $23.44 | $31.62 | $52.48 |
United Setting Professional Modifier TC · Technical part Typical Low $38.90 Median $53.70 Typical High $89.13 | Professional | TC · Technical part | $38.90 | $53.70 | $89.13 |
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 $41.69 Median $41.69 Typical High $41.69 | Professional | 52 · Reduced service | $41.69 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $16.60 Typical High $16.60 | Professional | 53 · Discontinued | $16.60 | $16.60 | $16.60 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $61.66 Typical High $63.10 | Professional | 54 · Surgery only | $61.66 | $61.66 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $12.30 Typical High $12.59 | Professional | 55 · Aftercare only | $12.30 | $12.30 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $8.32 Typical High $8.32 | Professional | 56 · Pre-op care only | $8.32 | $8.32 | $8.32 |
Where Virginia 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.
Virginia· 46th of 51
$58.88
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.