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 $3,715.35 Median $3,715.35 Typical High $3,981.07 | Facility | None | $3,715.35 | $3,715.35 | $3,981.07 |
Aetna Setting Professional Modifier None (both parts) Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | None (both parts) | $53.70 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | 26 · Professional part | $20.42 | $20.42 | $20.42 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | TC · Technical part | $33.88 | $33.88 | $33.88 |
BCBS Setting Facility Modifier None Typical Low $61.66 Median $81.28 Typical High $144.54 | Facility | None | $61.66 | $81.28 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Facility | None | $154.88 | $154.88 | $154.88 |
United Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Facility | None | $83.18 | $83.18 | $83.18 |
United Setting Professional Modifier None (both parts) Typical Low $50.12 Median $67.61 Typical High $89.13 | Professional | None (both parts) | $50.12 | $67.61 | $89.13 |
United Setting Professional Modifier 26 · Professional part Typical Low $19.05 Median $25.12 Typical High $33.11 | Professional | 26 · Professional part | $19.05 | $25.12 | $33.11 |
United Setting Professional Modifier TC · Technical part Typical Low $31.62 Median $41.69 Typical High $56.23 | Professional | TC · Technical part | $31.62 | $41.69 | $56.23 |
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 $26.92 Median $26.92 Typical High $26.92 | Professional | 52 · Reduced service | $26.92 | $26.92 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $10.72 Typical High $10.72 | Professional | 53 · Discontinued | $10.72 | $10.72 | $10.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | 54 · Surgery only | $40.74 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | 55 · Aftercare only | $8.13 | $8.13 | $8.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $5.37 Typical High $5.37 | Professional | 56 · Pre-op care only | $5.37 | $5.37 | $5.37 |
Where Rhode Island 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.
Rhode Island· 33rd of 51
$53.70
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.