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 $123.03 Median $123.03 Typical High $123.03 | Facility | None | $123.03 | $123.03 | $123.03 |
Aetna Setting Professional Modifier None (both parts) Typical Low $114.82 Median $123.03 Typical High $123.03 | Professional | None (both parts) | $114.82 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $33.11 Median $33.88 Typical High $33.88 | Professional | 26 · Professional part | $33.11 | $33.88 | $33.88 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $81.28 Median $87.10 Typical High $87.10 | Professional | TC · Technical part | $81.28 | $87.10 | $87.10 |
CareFirst Setting Professional Modifier None (both parts) Typical Low $109.65 Median $151.36 Typical High $177.83 | Professional | None (both parts) | $109.65 | $151.36 | $177.83 |
CareFirst Setting Professional Modifier 26 · Professional part Typical Low $41.69 Median $46.77 Typical High $46.77 | Professional | 26 · Professional part | $41.69 | $46.77 | $46.77 |
Cigna Setting Professional Modifier None (both parts) Typical Low $131.83 Median $154.88 Typical High $478.63 | Professional | None (both parts) | $131.83 | $154.88 | $478.63 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $37.15 Median $41.69 Typical High $128.82 | Professional | 26 · Professional part | $37.15 | $41.69 | $128.82 |
Cigna Setting Professional Modifier TC · Technical part Typical Low $95.50 Median $112.20 Typical High $346.74 | Professional | TC · Technical part | $95.50 | $112.20 | $346.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $131.83 Median $158.49 Typical High $316.23 | Professional | None | $131.83 | $158.49 | $316.23 |
United Setting Professional Modifier None (both parts) Typical Low $138.04 Median $229.09 Typical High $309.03 | Professional | None (both parts) | $138.04 | $229.09 | $309.03 |
United Setting Professional Modifier 26 · Professional part Typical Low $33.11 Median $51.29 Typical High $85.11 | Professional | 26 · Professional part | $33.11 | $51.29 | $85.11 |
United Setting Professional Modifier TC · Technical part Typical Low $102.33 Median $177.83 Typical High $245.47 | Professional | TC · Technical part | $102.33 | $177.83 | $245.47 |
4 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 $57.54 Median $60.26 Typical High $60.26 | Professional | 52 · Reduced service | $57.54 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $24.55 Typical High $24.55 | Professional | 53 · Discontinued | $23.44 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $18.20 Typical High $18.20 | Professional | 55 · Aftercare only | $17.38 | $18.20 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $12.30 Typical High $12.30 | Professional | 56 · Pre-op care only | $11.48 | $12.30 | $12.30 |
Where Washington, DC sits
The same service costs 3.2 times more in Kansas than in Utah. 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.
Washington, DC· 43rd of 51
$145
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.