How much rates vary
Facilitymedian $2,089 · 10th to 90th $39 to $12,023Professionalmedian $54 · 10th to 90th $30 to $63
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 $645.65 Median $4,786.30 Typical High $12,022.64 | Facility | None | $645.65 | $4,786.30 | $12,022.64 |
Aetna Setting Professional Modifier None (both parts) Typical Low $30.20 Median $51.29 Typical High $53.70 | Professional | None (both parts) | $30.20 | $51.29 | $53.70 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $12.02 Median $19.95 Typical High $20.42 | Professional | 26 · Professional part | $12.02 | $19.95 | $20.42 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $18.62 Median $30.90 Typical High $33.11 | Professional | TC · Technical part | $18.62 | $30.90 | $33.11 |
AvMed Setting Facility Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Facility | None | $38.90 | $38.90 | $38.90 |
AvMed Setting Professional Modifier None (both parts) Typical Low $26.92 Median $33.88 Typical High $37.15 | Professional | None (both parts) | $26.92 | $33.88 | $37.15 |
Cigna Setting Facility Modifier None Typical Low $67.61 Median $75.86 Typical High $95.50 | Facility | None | $67.61 | $75.86 | $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 |
Florida Blue Setting Facility Modifier None Typical Low $51.29 Median $53.70 Typical High $58.88 | Facility | None | $51.29 | $53.70 | $58.88 |
Florida Blue Setting Professional Modifier None (both parts) Typical Low $39.81 Median $53.70 Typical High $57.54 | Professional | None (both parts) | $39.81 | $53.70 | $57.54 |
Florida Blue Setting Professional Modifier 26 · Professional part Typical Low $14.13 Median $19.95 Typical High $20.89 | Professional | 26 · Professional part | $14.13 | $19.95 | $20.89 |
Florida Blue Setting Professional Modifier TC · Technical part Typical Low $25.12 Median $33.88 Typical High $37.15 | Professional | TC · Technical part | $25.12 | $33.88 | $37.15 |
Molina Setting Professional Modifier None (both parts) Typical Low $31.62 Median $50.12 Typical High $87.10 | Professional | None (both parts) | $31.62 | $50.12 | $87.10 |
United Setting Facility Modifier None Typical Low $43.65 Median $46.77 Typical High $46.77 | Facility | None | $43.65 | $46.77 | $46.77 |
United Setting Professional Modifier None (both parts) Typical Low $36.31 Median $48.98 Typical High $93.33 | Professional | None (both parts) | $36.31 | $48.98 | $93.33 |
United Setting Professional Modifier 26 · Professional part Typical Low $13.80 Median $18.62 Typical High $36.31 | Professional | 26 · Professional part | $13.80 | $18.62 | $36.31 |
United Setting Professional Modifier TC · Technical part Typical Low $22.91 Median $30.20 Typical High $56.23 | Professional | TC · Technical part | $22.91 | $30.20 | $56.23 |
Wellpoint Setting Professional Modifier None (both parts) Typical Low $53.70 Median $54.95 Typical High $54.95 | Professional | None (both parts) | $53.70 | $54.95 | $54.95 |
Wellpoint Setting Professional Modifier 26 · Professional part Typical Low $19.95 Median $24.55 Typical High $24.55 | Professional | 26 · Professional part | $19.95 | $24.55 | $24.55 |
Wellpoint Setting Professional Modifier TC · Technical part Typical Low $33.88 Median $38.90 Typical High $38.90 | Professional | TC · Technical part | $33.88 | $38.90 | $38.90 |
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 $15.14 Median $25.12 Typical High $26.92 | Professional | 52 · Reduced service | $15.14 | $25.12 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.03 Median $10.23 Typical High $10.72 | Professional | 53 · Discontinued | $6.03 | $10.23 | $10.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $22.91 Median $38.02 Typical High $40.74 | Professional | 54 · Surgery only | $22.91 | $38.02 | $40.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.57 Median $7.59 Typical High $8.13 | Professional | 55 · Aftercare only | $4.57 | $7.59 | $8.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.02 Median $5.13 Typical High $5.37 | Professional | 56 · Pre-op care only | $3.02 | $5.13 | $5.37 |
Where Florida 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.
Florida· 33rd of 51
$53.70
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.