How much rates vary
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 $29.51 Median $1,698.24 Typical High $2,511.89 | Facility | None | $29.51 | $1,698.24 | $2,511.89 |
Aetna Setting Professional Modifier None (both parts) Typical Low $29.51 Median $29.51 Typical High $33.11 | Professional | None (both parts) | $29.51 | $29.51 | $33.11 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $12.30 Median $12.30 Typical High $12.30 | Professional | 26 · Professional part | $12.30 | $12.30 | $12.30 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | TC · Technical part | $17.38 | $17.38 | $17.38 |
BCBS Arkansas Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $51.29 | Facility | None | $36.31 | $36.31 | $51.29 |
United Setting Facility Modifier None Typical Low $48.98 Median $60.26 Typical High $112.20 | Facility | None | $48.98 | $60.26 | $112.20 |
United Setting Professional Modifier None (both parts) Typical Low $45.71 Median $61.66 Typical High $100.00 | Professional | None (both parts) | $45.71 | $61.66 | $100.00 |
United Setting Professional Modifier 26 · Professional part Typical Low $17.38 Median $22.91 Typical High $41.69 | Professional | 26 · Professional part | $17.38 | $22.91 | $41.69 |
United Setting Professional Modifier TC · Technical part Typical Low $26.92 Median $36.31 Typical High $60.26 | Professional | TC · Technical part | $26.92 | $36.31 | $60.26 |
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 $14.79 Median $14.79 Typical High $14.79 | Professional | 52 · Reduced service | $14.79 | $14.79 | $14.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.89 Median $5.89 Typical High $5.89 | Professional | 53 · Discontinued | $5.89 | $5.89 | $5.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | 54 · Surgery only | $22.39 | $22.39 | $22.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.47 Median $4.47 Typical High $4.47 | Professional | 55 · Aftercare only | $4.47 | $4.47 | $4.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.95 Median $2.95 Typical High $2.95 | Professional | 56 · Pre-op care only | $2.95 | $2.95 | $2.95 |
Where Arkansas sits
The same service costs 3.3 times more in Nebraska 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.
Arkansas· 50th of 51
$36.31
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.