How much rates vary
Facilitymedian $62 · 10th to 90th $51 to $14,454Professionalmedian $95 · 10th to 90th $48 to $398
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 $51.29 Median $51.29 Typical High $14,454.40 | Facility | None | $51.29 | $51.29 | $14,454.40 |
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 $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 $31.62 Median $31.62 Typical High $31.62 | Professional | TC · Technical part | $31.62 | $31.62 | $31.62 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $47.86 Median $95.50 Typical High $398.11 | Professional | None (both parts) | $47.86 | $95.50 | $398.11 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $18.62 Median $39.81 Typical High $158.49 | Professional | 26 · Professional part | $18.62 | $39.81 | $158.49 |
Anthem BCBS Setting Professional Modifier TC · Technical part Typical Low $28.84 Median $61.66 Typical High $245.47 | Professional | TC · Technical part | $28.84 | $61.66 | $245.47 |
DeanCare Setting Facility Modifier None Typical Low $50.12 Median $61.66 Typical High $117.49 | Facility | None | $50.12 | $61.66 | $117.49 |
Medica Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $117.49 | Facility | None | $50.12 | $66.07 | $117.49 |
Medica Setting Professional Modifier None (both parts) Typical Low $56.23 Median $186.21 Typical High $398.11 | Professional | None (both parts) | $56.23 | $186.21 | $398.11 |
Medica Setting Professional Modifier 26 · Professional part Typical Low $21.88 Median $74.13 Typical High $158.49 | Professional | 26 · Professional part | $21.88 | $74.13 | $158.49 |
Medica Setting Professional Modifier TC · Technical part Typical Low $34.67 Median $114.82 Typical High $239.88 | Professional | TC · Technical part | $34.67 | $114.82 | $239.88 |
Prevea360 Setting Facility Modifier None Typical Low $50.12 Median $61.66 Typical High $117.49 | Facility | None | $50.12 | $61.66 | $117.49 |
Quartz Setting Professional Modifier None Typical Low $63.10 Median $109.65 Typical High $158.49 | Professional | None | $63.10 | $109.65 | $158.49 |
United Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
United Setting Professional Modifier None (both parts) Typical Low $56.23 Median $107.15 Typical High $346.74 | Professional | None (both parts) | $56.23 | $107.15 | $346.74 |
United Setting Professional Modifier 26 · Professional part Typical Low $21.38 Median $42.66 Typical High $134.90 | Professional | 26 · Professional part | $21.38 | $42.66 | $134.90 |
United Setting Professional Modifier TC · Technical part Typical Low $34.67 Median $66.07 Typical High $208.93 | Professional | TC · Technical part | $34.67 | $66.07 | $208.93 |
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 $10.47 Median $10.47 Typical High $10.47 | Professional | 53 · Discontinued | $10.47 | $10.47 | $10.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | 54 · Surgery only | $38.90 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $7.76 Typical High $7.76 | Professional | 55 · Aftercare only | $7.76 | $7.76 | $7.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $5.25 Typical High $5.25 | Professional | 56 · Pre-op care only | $5.25 | $5.25 | $5.25 |
Where Wisconsin 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.
Wisconsin· 3rd of 51
$95.50
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.