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 $138.04 Median $138.04 Typical High $138.04 | Facility | None | $138.04 | $138.04 | $138.04 |
Aetna Setting Professional Modifier None (both parts) Typical Low $114.82 Median $138.04 Typical High $147.91 | Professional | None (both parts) | $114.82 | $138.04 | $147.91 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $33.11 Median $41.69 Typical High $41.69 | Professional | 26 · Professional part | $33.11 | $41.69 | $41.69 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $81.28 Median $97.72 Typical High $109.65 | Professional | TC · Technical part | $81.28 | $97.72 | $109.65 |
Cigna Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Facility | None | $218.78 | $218.78 | $218.78 |
Cigna Setting Professional Modifier None (both parts) Typical Low $123.03 Median $162.18 Typical High $331.13 | Professional | None (both parts) | $123.03 | $162.18 | $331.13 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $35.48 Median $38.90 Typical High $66.07 | Professional | 26 · Professional part | $35.48 | $38.90 | $66.07 |
Cigna Setting Professional Modifier TC · Technical part Typical Low $87.10 Median $112.20 Typical High $263.03 | Professional | TC · Technical part | $87.10 | $112.20 | $263.03 |
United Setting Professional Modifier None (both parts) Typical Low $117.49 Median $181.97 Typical High $380.19 | Professional | None (both parts) | $117.49 | $181.97 | $380.19 |
United Setting Professional Modifier 26 · Professional part Typical Low $30.20 Median $42.66 Typical High $67.61 | Professional | 26 · Professional part | $30.20 | $42.66 | $67.61 |
United Setting Professional Modifier TC · Technical part Typical Low $87.10 Median $141.25 Typical High $338.84 | Professional | TC · Technical part | $87.10 | $141.25 | $338.84 |
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 $56.23 Median $69.18 Typical High $74.13 | Professional | 52 · Reduced service | $56.23 | $69.18 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $27.54 Typical High $29.51 | Professional | 53 · Discontinued | $22.91 | $27.54 | $29.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $20.89 Typical High $22.39 | Professional | 55 · Aftercare only | $16.98 | $20.89 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $13.80 Typical High $14.79 | Professional | 56 · Pre-op care only | $11.48 | $13.80 | $14.79 |
Where Delaware 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.
Delaware· 45th of 51
$141
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.