How much rates vary
Facilitymedian $72 · 10th to 90th $14 to $4,677Professionalmedian $55 · 10th to 90th $39 to $398
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 $977.24 Median $3,715.35 Typical High $7,585.78 | Facility | None | $977.24 | $3,715.35 | $7,585.78 |
Aetna Setting Professional Modifier None (both parts) Typical Low $52.48 Median $83.18 Typical High $83.18 | Professional | None (both parts) | $52.48 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $19.95 Median $31.62 Typical High $31.62 | Professional | 26 · Professional part | $19.95 | $31.62 | $31.62 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $33.11 Median $51.29 Typical High $51.29 | Professional | TC · Technical part | $33.11 | $51.29 | $51.29 |
BCBS Setting Facility Modifier None Typical Low $12.30 Median $53.70 Typical High $79.43 | Facility | None | $12.30 | $53.70 | $79.43 |
BCBS Setting Professional Modifier None (both parts) Typical Low $28.84 Median $38.90 Typical High $54.95 | Professional | None (both parts) | $28.84 | $38.90 | $54.95 |
BCBS Setting Professional Modifier 26 · Professional part Typical Low $17.38 Median $22.91 Typical High $33.11 | Professional | 26 · Professional part | $17.38 | $22.91 | $33.11 |
BCBS Setting Professional Modifier TC · Technical part Typical Low $11.75 Median $15.49 Typical High $22.39 | Professional | TC · Technical part | $11.75 | $15.49 | $22.39 |
Medica Setting Facility Modifier None Typical Low $61.66 Median $91.20 Typical High $138.04 | Facility | None | $61.66 | $91.20 | $138.04 |
Medica Setting Professional Modifier None (both parts) Typical Low $47.86 Median $141.25 Typical High $398.11 | Professional | None (both parts) | $47.86 | $141.25 | $398.11 |
Medica Setting Professional Modifier 26 · Professional part Typical Low $18.20 Median $57.54 Typical High $158.49 | Professional | 26 · Professional part | $18.20 | $57.54 | $158.49 |
Medica Setting Professional Modifier TC · Technical part Typical Low $29.51 Median $93.33 Typical High $239.88 | Professional | TC · Technical part | $29.51 | $93.33 | $239.88 |
United Setting Professional Modifier None (both parts) Typical Low $46.77 Median $52.48 Typical High $91.20 | Professional | None (both parts) | $46.77 | $52.48 | $91.20 |
United Setting Professional Modifier 26 · Professional part Typical Low $17.78 Median $19.95 Typical High $34.67 | Professional | 26 · Professional part | $17.78 | $19.95 | $34.67 |
United Setting Professional Modifier TC · Technical part Typical Low $28.84 Median $32.36 Typical High $56.23 | Professional | TC · Technical part | $28.84 | $32.36 | $56.23 |
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 $26.30 Median $41.69 Typical High $41.69 | Professional | 52 · Reduced service | $26.30 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $16.60 Typical High $16.60 | Professional | 53 · Discontinued | $10.72 | $16.60 | $16.60 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $39.81 Median $61.66 Typical High $61.66 | Professional | 54 · Surgery only | $39.81 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $12.59 Typical High $12.59 | Professional | 55 · Aftercare only | $7.94 | $12.59 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $8.32 Typical High $8.32 | Professional | 56 · Pre-op care only | $5.25 | $8.32 | $8.32 |
Where Arizona 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.
Arizona· 26th of 51
$54.95
NE $112NY $33.88
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.