How much rates vary
Facilitymedian $91 · 10th to 90th $56 to $6,310Professionalmedian $74 · 10th to 90th $50 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 $50.12 Median $5,888.44 Typical High $7,943.28 | Facility | None | $50.12 | $5,888.44 | $7,943.28 |
Aetna Setting Professional Modifier None (both parts) Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | None (both parts) | $50.12 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $19.50 Median $20.42 Typical High $20.42 | Professional | 26 · Professional part | $19.50 | $20.42 | $20.42 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | TC · Technical part | $30.20 | $30.20 | $30.20 |
Cigna Setting Professional Modifier None (both parts) Typical Low $67.61 Median $85.11 Typical High $85.11 | Professional | None (both parts) | $67.61 | $85.11 | $85.11 |
Hally Health Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
Medica Setting Facility Modifier None Typical Low $61.66 Median $81.28 Typical High $123.03 | Facility | None | $61.66 | $81.28 | $123.03 |
Medica Setting Professional Modifier None (both parts) Typical Low $54.95 Median $102.33 Typical High $398.11 | Professional | None (both parts) | $54.95 | $102.33 | $398.11 |
Medica Setting Professional Modifier 26 · Professional part Typical Low $23.99 Median $52.48 Typical High $158.49 | Professional | 26 · Professional part | $23.99 | $52.48 | $158.49 |
Medica Setting Professional Modifier TC · Technical part Typical Low $30.90 Median $69.18 Typical High $239.88 | Professional | TC · Technical part | $30.90 | $69.18 | $239.88 |
Midlands Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $112.20 | Professional | None | $67.61 | $67.61 | $112.20 |
United Setting Facility Modifier None Typical Low $56.23 Median $93.33 Typical High $117.49 | Facility | None | $56.23 | $93.33 | $117.49 |
United Setting Professional Modifier None (both parts) Typical Low $53.70 Median $74.13 Typical High $141.25 | Professional | None (both parts) | $53.70 | $74.13 | $141.25 |
United Setting Professional Modifier 26 · Professional part Typical Low $22.91 Median $33.11 Typical High $63.10 | Professional | 26 · Professional part | $22.91 | $33.11 | $63.10 |
United Setting Professional Modifier TC · Technical part Typical Low $29.51 Median $41.69 Typical High $77.62 | Professional | TC · Technical part | $29.51 | $41.69 | $77.62 |
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 $24.55 Median $25.12 Typical High $25.12 | Professional | 52 · Reduced service | $24.55 | $25.12 | $25.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $10.00 Typical High $10.00 | Professional | 53 · Discontinued | $10.00 | $10.00 | $10.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $37.15 Median $38.02 Typical High $38.02 | Professional | 54 · Surgery only | $37.15 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $7.59 Typical High $7.59 | Professional | 55 · Aftercare only | $7.41 | $7.59 | $7.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $5.01 Typical High $5.01 | Professional | 56 · Pre-op care only | $5.01 | $5.01 | $5.01 |
Where Iowa 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.
Iowa· 8th of 51
$79.43
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.