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 $1,412.54 Median $1,412.54 Typical High $1,412.54 | Facility | None | $1,412.54 | $1,412.54 | $1,412.54 |
Aetna Setting Professional Modifier None (both parts) Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | None (both parts) | $47.86 | $47.86 | $47.86 |
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 $28.18 Median $28.18 Typical High $28.18 | Professional | TC · Technical part | $28.18 | $28.18 | $28.18 |
Cigna Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Facility | None | $95.50 | $95.50 | $95.50 |
Cigna Setting Professional Modifier None (both parts) Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | None (both parts) | $269.15 | $269.15 | $269.15 |
United Setting Facility Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Facility | None | $104.71 | $104.71 | $104.71 |
United Setting Professional Modifier None (both parts) Typical Low $39.81 Median $56.23 Typical High $120.23 | Professional | None (both parts) | $39.81 | $56.23 | $120.23 |
United Setting Professional Modifier 26 · Professional part Typical Low $15.49 Median $20.89 Typical High $50.12 | Professional | 26 · Professional part | $15.49 | $20.89 | $50.12 |
United Setting Professional Modifier TC · Technical part Typical Low $23.44 Median $35.48 Typical High $69.18 | Professional | TC · Technical part | $23.44 | $35.48 | $69.18 |
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 $23.99 | Professional | 52 · Reduced service | $23.99 | $23.99 | $23.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $9.55 Typical High $9.55 | Professional | 53 · Discontinued | $9.55 | $9.55 | $9.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | 54 · Surgery only | $35.48 | $35.48 | $35.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $7.08 Typical High $7.08 | Professional | 55 · Aftercare only | $7.08 | $7.08 | $7.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $4.79 Typical High $4.79 | Professional | 56 · Pre-op care only | $4.79 | $4.79 | $4.79 |
Where West Virginia 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.
West Virginia· 44th of 51
$47.86
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.