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 $54.95 Median $1,698.24 Typical High $7,943.28 | Facility | None | $54.95 | $1,698.24 | $7,943.28 |
Aetna Setting Professional Modifier None (both parts) Typical Low $50.12 Median $54.95 Typical High $54.95 | Professional | None (both parts) | $50.12 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $19.50 Median $19.95 Typical High $19.95 | Professional | 26 · Professional part | $19.50 | $19.95 | $19.95 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $31.62 Median $35.48 Typical High $35.48 | Professional | TC · Technical part | $31.62 | $35.48 | $35.48 |
Kaiser Permanente Setting Professional Modifier None Typical Low $53.70 Median $64.57 Typical High $123.03 | Professional | None | $53.70 | $64.57 | $123.03 |
United Setting Professional Modifier None (both parts) Typical Low $46.77 Median $77.62 Typical High $134.90 | Professional | None (both parts) | $46.77 | $77.62 | $134.90 |
United Setting Professional Modifier 26 · Professional part Typical Low $16.60 Median $27.54 Typical High $45.71 | Professional | 26 · Professional part | $16.60 | $27.54 | $45.71 |
United Setting Professional Modifier TC · Technical part Typical Low $30.20 Median $50.12 Typical High $89.13 | Professional | TC · Technical part | $30.20 | $50.12 | $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 $25.12 Median $27.54 Typical High $27.54 | Professional | 52 · Reduced service | $25.12 | $27.54 | $27.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $10.96 Typical High $10.96 | Professional | 53 · Discontinued | $10.00 | $10.96 | $10.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.02 Median $41.69 Typical High $41.69 | Professional | 54 · Surgery only | $38.02 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $8.32 Typical High $8.32 | Professional | 55 · Aftercare only | $7.59 | $8.32 | $8.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $5.50 Typical High $5.50 | Professional | 56 · Pre-op care only | $5.01 | $5.50 | $5.50 |
Where Washington, DC 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.
Washington, DC· 27th of 51
$54.95
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.