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 $41.69 Median $41.69 Typical High $7,244.36 | Facility | None | $41.69 | $41.69 | $7,244.36 |
Aetna Setting Professional Modifier None (both parts) Typical Low $41.69 Median $41.69 Typical High $54.95 | Professional | None (both parts) | $41.69 | $41.69 | $54.95 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $15.85 Median $15.85 Typical High $20.89 | Professional | 26 · Professional part | $15.85 | $15.85 | $20.89 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $26.30 Median $26.30 Typical High $35.48 | Professional | TC · Technical part | $26.30 | $26.30 | $35.48 |
Cigna Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Facility | None | $95.50 | $95.50 | $95.50 |
Cigna Setting Professional Modifier None (both parts) Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | None (both parts) | $269.15 | $269.15 | $269.15 |
United Setting Professional Modifier None (both parts) Typical Low $43.65 Median $58.88 Typical High $97.72 | Professional | None (both parts) | $43.65 | $58.88 | $97.72 |
United Setting Professional Modifier 26 · Professional part Typical Low $15.49 Median $21.88 Typical High $37.15 | Professional | 26 · Professional part | $15.49 | $21.88 | $37.15 |
United Setting Professional Modifier TC · Technical part Typical Low $27.54 Median $35.48 Typical High $60.26 | Professional | TC · Technical part | $27.54 | $35.48 | $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 $20.89 Median $20.89 Typical High $27.54 | Professional | 52 · Reduced service | $20.89 | $20.89 | $27.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $8.32 Typical High $10.96 | Professional | 53 · Discontinued | $8.32 | $8.32 | $10.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $31.62 Median $31.62 Typical High $41.69 | Professional | 54 · Surgery only | $31.62 | $31.62 | $41.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $6.31 Typical High $8.32 | Professional | 55 · Aftercare only | $6.31 | $6.31 | $8.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $4.17 Typical High $5.50 | Professional | 56 · Pre-op care only | $4.17 | $4.17 | $5.50 |
Where Delaware 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.
Delaware· 46th of 51
$45.71
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.