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 $50.12 Median $5,370.32 Typical High $7,943.28 | Facility | None | $50.12 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None (both parts) Typical Low $47.86 Median $50.12 Typical High $50.12 | Professional | None (both parts) | $47.86 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $19.05 Median $19.05 Typical High $19.50 | Professional | 26 · Professional part | $19.05 | $19.05 | $19.50 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $28.18 Median $30.90 Typical High $30.90 | Professional | TC · Technical part | $28.18 | $30.90 | $30.90 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $50.12 Median $50.12 Typical High $102.33 | Professional | None (both parts) | $50.12 | $50.12 | $102.33 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $19.50 Median $19.50 Typical High $37.15 | Professional | 26 · Professional part | $19.50 | $19.50 | $37.15 |
Anthem BCBS Setting Professional Modifier TC · Technical part Typical Low $30.90 Median $30.90 Typical High $66.07 | Professional | TC · Technical part | $30.90 | $30.90 | $66.07 |
Kaiser Permanente Setting Professional Modifier None Typical Low $50.12 Median $60.26 Typical High $85.11 | Professional | None | $50.12 | $60.26 | $85.11 |
United Setting Professional Modifier None (both parts) Typical Low $45.71 Median $67.61 Typical High $151.36 | Professional | None (both parts) | $45.71 | $67.61 | $151.36 |
United Setting Professional Modifier 26 · Professional part Typical Low $17.38 Median $26.92 Typical High $57.54 | Professional | 26 · Professional part | $17.38 | $26.92 | $57.54 |
United Setting Professional Modifier TC · Technical part Typical Low $28.18 Median $41.69 Typical High $93.33 | Professional | TC · Technical part | $28.18 | $41.69 | $93.33 |
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 $23.99 Median $24.55 Typical High $24.55 | Professional | 52 · Reduced service | $23.99 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $10.00 Typical High $10.00 | Professional | 53 · Discontinued | $9.55 | $10.00 | $10.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $37.15 Typical High $37.15 | Professional | 54 · Surgery only | $35.48 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $7.41 Typical High $7.41 | Professional | 55 · Aftercare only | $7.08 | $7.41 | $7.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $5.01 Typical High $5.01 | Professional | 56 · Pre-op care only | $4.79 | $5.01 | $5.01 |
Where Georgia 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.
Georgia· 39th of 51
$50.12
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.