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 $1,949.84 Median $5,495.41 Typical High $9,549.93 | Facility | None | $1,949.84 | $5,495.41 | $9,549.93 |
Aetna Setting Professional Modifier None (both parts) Typical Low $48.98 Median $48.98 Typical High $52.48 | Professional | None (both parts) | $48.98 | $48.98 | $52.48 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $19.50 Median $19.50 Typical High $20.89 | Professional | 26 · Professional part | $19.50 | $19.50 | $20.89 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $28.84 Median $28.84 Typical High $31.62 | Professional | TC · Technical part | $28.84 | $28.84 | $31.62 |
BCBS Kansas Setting Professional Modifier None (both parts) Typical Low $26.92 Median $33.11 Typical High $60.26 | Professional | None (both parts) | $26.92 | $33.11 | $60.26 |
Cigna Setting Facility Modifier None Typical Low $38.02 Median $91.20 Typical High $123.03 | Facility | None | $38.02 | $91.20 | $123.03 |
Medica Setting Facility Modifier None Typical Low $41.69 Median $51.29 Typical High $138.04 | Facility | None | $41.69 | $51.29 | $138.04 |
Medica Setting Professional Modifier None (both parts) Typical Low $57.54 Median $83.18 Typical High $398.11 | Professional | None (both parts) | $57.54 | $83.18 | $398.11 |
Medica Setting Professional Modifier 26 · Professional part Typical Low $25.70 Median $36.31 Typical High $158.49 | Professional | 26 · Professional part | $25.70 | $36.31 | $158.49 |
Medica Setting Professional Modifier TC · Technical part Typical Low $33.88 Median $45.71 Typical High $239.88 | Professional | TC · Technical part | $33.88 | $45.71 | $239.88 |
United Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $69.18 | Facility | None | $43.65 | $43.65 | $69.18 |
United Setting Professional Modifier None (both parts) Typical Low $53.70 Median $72.44 Typical High $85.11 | Professional | None (both parts) | $53.70 | $72.44 | $85.11 |
United Setting Professional Modifier 26 · Professional part Typical Low $21.38 Median $31.62 Typical High $37.15 | Professional | 26 · Professional part | $21.38 | $31.62 | $37.15 |
United Setting Professional Modifier TC · Technical part Typical Low $31.62 Median $40.74 Typical High $47.86 | Professional | TC · Technical part | $31.62 | $40.74 | $47.86 |
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 $23.99 Typical High $26.30 | Professional | 52 · Reduced service | $23.99 | $23.99 | $26.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $9.77 Typical High $10.47 | Professional | 53 · Discontinued | $9.77 | $9.77 | $10.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $36.31 Median $36.31 Typical High $39.81 | Professional | 54 · Surgery only | $36.31 | $36.31 | $39.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $7.24 Typical High $7.94 | Professional | 55 · Aftercare only | $7.24 | $7.24 | $7.94 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $4.79 Typical High $5.25 | Professional | 56 · Pre-op care only | $4.79 | $4.79 | $5.25 |
Where Kansas 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.
Kansas· 16th of 51
$60.26
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.