How much rates vary
Professionalmedian $62 · 10th to 90th $51 to $100
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 Professional Modifier None (both parts) Typical Low $51.29 Median $51.29 Typical High $51.29 | Professional | None (both parts) | $51.29 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | 26 · Professional part | $19.50 | $19.50 | $19.50 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | TC · Technical part | $31.62 | $31.62 | $31.62 |
United Setting Professional Modifier None (both parts) Typical Low $53.70 Median $74.13 Typical High $112.20 | Professional | None (both parts) | $53.70 | $74.13 | $112.20 |
United Setting Professional Modifier 26 · Professional part Typical Low $21.38 Median $28.18 Typical High $42.66 | Professional | 26 · Professional part | $21.38 | $28.18 | $42.66 |
United Setting Professional Modifier TC · Technical part Typical Low $33.11 Median $46.77 Typical High $70.79 | Professional | TC · Technical part | $33.11 | $46.77 | $70.79 |
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 $25.70 Median $25.70 Typical High $25.70 | Professional | 52 · Reduced service | $25.70 | $25.70 | $25.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $10.23 Typical High $10.23 | Professional | 53 · Discontinued | $10.23 | $10.23 | $10.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | 54 · Surgery only | $38.02 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $7.59 Typical High $7.59 | Professional | 55 · Aftercare only | $7.59 | $7.59 | $7.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $5.13 Typical High $5.13 | Professional | 56 · Pre-op care only | $5.13 | $5.13 | $5.13 |