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 $1,000.00 Median $3,890.45 Typical High $18,620.87 | Facility | None | $1,000.00 | $3,890.45 | $18,620.87 |
Aetna Setting Professional Modifier None (both parts) Typical Low $41.69 Median $41.69 Typical High $48.98 | Professional | None (both parts) | $41.69 | $41.69 | $48.98 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $16.60 Median $16.60 Typical High $17.78 | Professional | 26 · Professional part | $16.60 | $16.60 | $17.78 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $24.55 Median $24.55 Typical High $28.84 | Professional | TC · Technical part | $24.55 | $24.55 | $28.84 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Facility | None | $138.04 | $138.04 | $138.04 |
Medica Setting Facility Modifier None Typical Low $37.15 Median $45.71 Typical High $245.47 | Facility | None | $37.15 | $45.71 | $245.47 |
Medica Setting Professional Modifier None (both parts) Typical Low $44.67 Median $75.86 Typical High $398.11 | Professional | None (both parts) | $44.67 | $75.86 | $398.11 |
Medica Setting Professional Modifier 26 · Professional part Typical Low $17.38 Median $28.84 Typical High $158.49 | Professional | 26 · Professional part | $17.38 | $28.84 | $158.49 |
Medica Setting Professional Modifier TC · Technical part Typical Low $27.54 Median $45.71 Typical High $239.88 | Professional | TC · Technical part | $27.54 | $45.71 | $239.88 |
United Setting Facility Modifier None Typical Low $16.22 Median $60.26 Typical High $97.72 | Facility | None | $16.22 | $60.26 | $97.72 |
United Setting Professional Modifier None (both parts) Typical Low $43.65 Median $53.70 Typical High $85.11 | Professional | None (both parts) | $43.65 | $53.70 | $85.11 |
United Setting Professional Modifier 26 · Professional part Typical Low $16.60 Median $20.42 Typical High $32.36 | Professional | 26 · Professional part | $16.60 | $20.42 | $32.36 |
United Setting Professional Modifier TC · Technical part Typical Low $26.92 Median $33.88 Typical High $52.48 | Professional | TC · Technical part | $26.92 | $33.88 | $52.48 |
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 $20.42 Median $20.42 Typical High $23.99 | Professional | 52 · Reduced service | $20.42 | $20.42 | $23.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $8.32 Typical High $9.77 | Professional | 53 · Discontinued | $8.32 | $8.32 | $9.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | 54 · Surgery only | $30.90 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $6.17 Typical High $7.24 | Professional | 55 · Aftercare only | $6.17 | $6.17 | $7.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $4.17 Typical High $4.79 | Professional | 56 · Pre-op care only | $4.17 | $4.17 | $4.79 |
Where Oklahoma 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.
Oklahoma· 23rd of 51
$57.54
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.