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 Professional Modifier None (both parts) Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | None (both parts) | $112.20 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | 26 · Professional part | $36.31 | $36.31 | $36.31 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | TC · Technical part | $74.13 | $74.13 | $74.13 |
CareSource Setting Professional Modifier None (both parts) Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | None (both parts) | $40.74 | $40.74 | $40.74 |
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 $120.23 Median $223.87 Typical High $1,202.26 | Professional | None (both parts) | $120.23 | $223.87 | $1,202.26 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $33.88 Median $57.54 Typical High $181.97 | Professional | 26 · Professional part | $33.88 | $57.54 | $181.97 |
Cigna Setting Professional Modifier TC · Technical part Typical Low $85.11 Median $173.78 Typical High $616.60 | Professional | TC · Technical part | $85.11 | $173.78 | $616.60 |
United Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Facility | None | $363.08 | $363.08 | $363.08 |
United Setting Professional Modifier None (both parts) Typical Low $102.33 Median $208.93 Typical High $446.68 | Professional | None (both parts) | $102.33 | $208.93 | $446.68 |
United Setting Professional Modifier 26 · Professional part Typical Low $29.51 Median $39.81 Typical High $95.50 | Professional | 26 · Professional part | $29.51 | $39.81 | $95.50 |
United Setting Professional Modifier TC · Technical part Typical Low $72.44 Median $165.96 Typical High $354.81 | Professional | TC · Technical part | $72.44 | $165.96 | $354.81 |
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 $54.95 Median $54.95 Typical High $54.95 | Professional | 52 · Reduced service | $54.95 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | 53 · Discontinued | $22.39 | $22.39 | $22.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $16.60 Typical High $16.60 | Professional | 55 · Aftercare only | $16.60 | $16.60 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $11.22 Typical High $11.22 | Professional | 56 · Pre-op care only | $11.22 | $11.22 | $11.22 |
Where West Virginia 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.
West Virginia· 23rd of 51
$186
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.