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 $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Aetna Setting Professional Modifier None (both parts) Typical Low $104.71 Median $104.71 Typical High $141.25 | Professional | None (both parts) | $104.71 | $104.71 | $141.25 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $67.61 Median $67.61 Typical High $91.20 | Professional | 26 · Professional part | $67.61 | $67.61 | $91.20 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $36.31 Median $36.31 Typical High $48.98 | Professional | TC · Technical part | $36.31 | $36.31 | $48.98 |
Cigna Setting Professional Modifier None (both parts) Typical Low $158.49 Median $169.82 Typical High $269.15 | Professional | None (both parts) | $158.49 | $169.82 | $269.15 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $100.00 Median $104.71 Typical High $165.96 | Professional | 26 · Professional part | $100.00 | $104.71 | $165.96 |
Cigna Setting Professional Modifier TC · Technical part Typical Low $60.26 Median $66.07 Typical High $104.71 | Professional | TC · Technical part | $60.26 | $66.07 | $104.71 |
Medica Setting Facility Modifier None Typical Low $138.04 Median $173.78 Typical High $281.84 | Facility | None | $138.04 | $173.78 | $281.84 |
Medica Setting Professional Modifier None (both parts) Typical Low $61.66 Median $112.20 Typical High $630.96 | Professional | None (both parts) | $61.66 | $112.20 | $630.96 |
Medica Setting Professional Modifier 26 · Professional part Typical Low $38.90 Median $75.86 Typical High $407.38 | Professional | 26 · Professional part | $38.90 | $75.86 | $407.38 |
Medica Setting Professional Modifier TC · Technical part Typical Low $20.89 Median $36.31 Typical High $218.78 | Professional | TC · Technical part | $20.89 | $36.31 | $218.78 |
Midlands Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | None | $190.55 | $190.55 | $190.55 |
United Setting Facility Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Facility | None | $812.83 | $812.83 | $812.83 |
United Setting Professional Modifier None (both parts) Typical Low $58.88 Median $107.15 Typical High $165.96 | Professional | None (both parts) | $58.88 | $107.15 | $165.96 |
United Setting Professional Modifier 26 · Professional part Typical Low $35.48 Median $70.79 Typical High $104.71 | Professional | 26 · Professional part | $35.48 | $70.79 | $104.71 |
United Setting Professional Modifier TC · Technical part Typical Low $19.05 Median $36.31 Typical High $60.26 | Professional | TC · Technical part | $19.05 | $36.31 | $60.26 |
2 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 55 · Aftercare only Typical Low $15.49 Median $15.49 Typical High $21.38 | Professional | 55 · Aftercare only | $15.49 | $15.49 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $10.47 Typical High $14.13 | Professional | 56 · Pre-op care only | $10.47 | $10.47 | $14.13 |
Where South Dakota sits
The same service costs 4.4 times more in Minnesota than in Alabama. 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.
South Dakota· 8th of 51
$162
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.