How much rates vary
Facilitymedian $513 · 10th to 90th $110 to $871Professionalmedian $708 · 10th to 90th $513 to $1,230
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 Facility Modifier None Typical Low $512.86 Median $602.56 Typical High $794.33 | Facility | None | $512.86 | $602.56 | $794.33 |
Aetna Setting Professional Modifier None (both parts) Typical Low $512.86 Median $549.54 Typical High $741.31 | Professional | None (both parts) | $512.86 | $549.54 | $741.31 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $389.05 Median $416.87 Typical High $489.78 | Professional | 26 · Professional part | $389.05 | $416.87 | $489.78 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $120.23 Median $131.83 Typical High $173.78 | Professional | TC · Technical part | $120.23 | $131.83 | $173.78 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $588.84 Median $691.83 Typical High $954.99 | Professional | None (both parts) | $588.84 | $691.83 | $954.99 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $331.13 Median $426.58 Typical High $575.44 | Professional | 26 · Professional part | $331.13 | $426.58 | $575.44 |
Anthem BCBS Setting Professional Modifier TC · Technical part Typical Low $223.87 Median $263.03 Typical High $363.08 | Professional | TC · Technical part | $223.87 | $263.03 | $363.08 |
CareSource Setting Facility Modifier None Typical Low $109.65 Median $363.08 Typical High $575.44 | Facility | None | $109.65 | $363.08 | $575.44 |
CareSource Setting Professional Modifier None (both parts) Typical Low $120.23 Median $151.36 Typical High $177.83 | Professional | None (both parts) | $120.23 | $151.36 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $870.96 | Facility | None | $870.96 | $870.96 | $870.96 |
Cigna Setting Facility Modifier 26 · Professional part Typical Low $100.00 Median $467.74 Typical High $676.08 | Facility | 26 · Professional part | $100.00 | $467.74 | $676.08 |
Cigna Setting Facility Modifier TC · Technical part Typical Low $30.90 Median $144.54 Typical High $208.93 | Facility | TC · Technical part | $30.90 | $144.54 | $208.93 |
Cigna Setting Professional Modifier None (both parts) Typical Low $478.63 Median $1,047.13 Typical High $2,884.03 | Professional | None (both parts) | $478.63 | $1,047.13 | $2,884.03 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $371.54 Median $741.31 Typical High $1,905.46 | Professional | 26 · Professional part | $371.54 | $741.31 | $1,905.46 |
Cigna Setting Professional Modifier TC · Technical part Typical Low $112.20 Median $229.09 Typical High $1,479.11 | Professional | TC · Technical part | $112.20 | $229.09 | $1,479.11 |
Molina Setting Professional Modifier None (both parts) Typical Low $33.11 Median $33.11 Typical High $707.95 | Professional | None (both parts) | $33.11 | $33.11 | $707.95 |
United Setting Facility Modifier None Typical Low $77.62 Median $251.19 Typical High $1,380.38 | Facility | None | $77.62 | $251.19 | $1,380.38 |
United Setting Professional Modifier None (both parts) Typical Low $676.08 Median $933.25 Typical High $1,380.38 | Professional | None (both parts) | $676.08 | $933.25 | $1,380.38 |
United Setting Professional Modifier 26 · Professional part Typical Low $407.38 Median $537.03 Typical High $724.44 | Professional | 26 · Professional part | $407.38 | $537.03 | $724.44 |
United Setting Professional Modifier TC · Technical part Typical Low $263.03 Median $371.54 Typical High $616.60 | Professional | TC · Technical part | $263.03 | $371.54 | $616.60 |
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 $257.04 Median $269.15 Typical High $331.13 | Professional | 52 · Reduced service | $257.04 | $269.15 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $109.65 Typical High $131.83 | Professional | 53 · Discontinued | $102.33 | $109.65 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $407.38 Typical High $501.19 | Professional | 54 · Surgery only | $380.19 | $407.38 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $81.28 Typical High $100.00 | Professional | 55 · Aftercare only | $77.62 | $81.28 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $54.95 Typical High $66.07 | Professional | 56 · Pre-op care only | $51.29 | $54.95 | $66.07 |
Where Kentucky sits
The same service costs 5.6 times more in Nebraska than in Maryland. 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.
Kentucky· 37th of 51
$708
NE $2,818MD $501
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.