How much rates vary
Facilitymedian $81 · 10th to 90th $68 to $14,454Professionalmedian $141 · 10th to 90th $68 to $550
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 $67.61 Median $67.61 Typical High $14,454.40 | Facility | None | $67.61 | $67.61 | $14,454.40 |
Aetna Setting Professional Modifier None (both parts) Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | None (both parts) | $67.61 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $26.30 Median $26.30 Typical High $26.30 | Professional | 26 · Professional part | $26.30 | $26.30 | $26.30 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | TC · Technical part | $41.69 | $41.69 | $41.69 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $70.79 Median $151.36 Typical High $575.44 | Professional | None (both parts) | $70.79 | $151.36 | $575.44 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $27.54 Median $58.88 Typical High $223.87 | Professional | 26 · Professional part | $27.54 | $58.88 | $223.87 |
Anthem BCBS Setting Professional Modifier TC · Technical part Typical Low $43.65 Median $91.20 Typical High $354.81 | Professional | TC · Technical part | $43.65 | $91.20 | $354.81 |
DeanCare Setting Facility Modifier None Typical Low $69.18 Median $81.28 Typical High $151.36 | Facility | None | $69.18 | $81.28 | $151.36 |
Medica Setting Facility Modifier None Typical Low $69.18 Median $87.10 Typical High $151.36 | Facility | None | $69.18 | $87.10 | $151.36 |
Medica Setting Professional Modifier None (both parts) Typical Low $83.18 Median $275.42 Typical High $549.54 | Professional | None (both parts) | $83.18 | $275.42 | $549.54 |
Medica Setting Professional Modifier 26 · Professional part Typical Low $32.36 Median $109.65 Typical High $218.78 | Professional | 26 · Professional part | $32.36 | $109.65 | $218.78 |
Medica Setting Professional Modifier TC · Technical part Typical Low $50.12 Median $169.82 Typical High $331.13 | Professional | TC · Technical part | $50.12 | $169.82 | $331.13 |
Prevea360 Setting Facility Modifier None Typical Low $69.18 Median $81.28 Typical High $151.36 | Facility | None | $69.18 | $81.28 | $151.36 |
Quartz Setting Professional Modifier None Typical Low $81.28 Median $151.36 Typical High $234.42 | Professional | None | $81.28 | $151.36 | $234.42 |
United Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
United Setting Professional Modifier None (both parts) Typical Low $81.28 Median $158.49 Typical High $512.86 | Professional | None (both parts) | $81.28 | $158.49 | $512.86 |
United Setting Professional Modifier 26 · Professional part Typical Low $32.36 Median $64.57 Typical High $199.53 | Professional | 26 · Professional part | $32.36 | $64.57 | $199.53 |
United Setting Professional Modifier TC · Technical part Typical Low $45.71 Median $97.72 Typical High $309.03 | Professional | TC · Technical part | $45.71 | $97.72 | $309.03 |
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 $33.88 Median $33.88 Typical High $33.88 | Professional | 52 · Reduced service | $33.88 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $13.49 Typical High $13.49 | Professional | 53 · Discontinued | $13.49 | $13.49 | $13.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $51.29 Typical High $51.29 | Professional | 54 · Surgery only | $51.29 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $10.23 Typical High $10.23 | Professional | 55 · Aftercare only | $10.23 | $10.23 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $6.76 Typical High $6.76 | Professional | 56 · Pre-op care only | $6.76 | $6.76 | $6.76 |
Where Wisconsin 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.
Wisconsin· 3rd of 51
$141
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.