How much rates vary
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 $169.82 Median $213.80 Typical High $213.80 | Professional | None (both parts) | $169.82 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | 26 · Professional part | $43.65 | $43.65 | $43.65 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $131.83 Median $173.78 Typical High $173.78 | Professional | TC · Technical part | $131.83 | $173.78 | $173.78 |
Cigna Setting Professional Modifier None (both parts) Typical Low $234.42 Median $281.84 Typical High $371.54 | Professional | None (both parts) | $234.42 | $281.84 | $371.54 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $50.12 Median $81.28 Typical High $81.28 | Professional | 26 · Professional part | $50.12 | $81.28 | $81.28 |
Cigna Setting Professional Modifier TC · Technical part Typical Low $186.21 Median $204.17 Typical High $302.00 | Professional | TC · Technical part | $186.21 | $204.17 | $302.00 |
MVP Health Care Setting Professional Modifier None (both parts) Typical Low $169.82 Median $208.93 Typical High $446.68 | Professional | None (both parts) | $169.82 | $208.93 | $446.68 |
United Setting Professional Modifier None (both parts) Typical Low $144.54 Median $199.53 Typical High $371.54 | Professional | None (both parts) | $144.54 | $199.53 | $371.54 |
United Setting Professional Modifier 26 · Professional part Typical Low $38.90 Median $52.48 Typical High $75.86 | Professional | 26 · Professional part | $38.90 | $52.48 | $75.86 |
United Setting Professional Modifier TC · Technical part Typical Low $104.71 Median $147.91 Typical High $295.12 | Professional | TC · Technical part | $104.71 | $147.91 | $295.12 |
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 $85.11 Median $107.15 Typical High $107.15 | Professional | 52 · Reduced service | $85.11 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $43.65 Typical High $43.65 | Professional | 53 · Discontinued | $33.88 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $32.36 Typical High $32.36 | Professional | 55 · Aftercare only | $25.12 | $32.36 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $21.38 Typical High $21.38 | Professional | 56 · Pre-op care only | $16.98 | $21.38 | $21.38 |
Where Vermont 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.
Vermont· 5th of 51
$282
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.