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 $831.76 Median $831.76 Typical High $891.25 | Professional | None (both parts) | $831.76 | $831.76 | $891.25 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $177.83 Median $177.83 Typical High $186.21 | Professional | 26 · Professional part | $177.83 | $177.83 | $186.21 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $660.69 Median $660.69 Typical High $707.95 | Professional | TC · Technical part | $660.69 | $660.69 | $707.95 |
CareSource Setting Professional Modifier None (both parts) Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | None (both parts) | $194.98 | $194.98 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Facility | None | $1,479.11 | $1,479.11 | $1,479.11 |
Cigna Setting Professional Modifier None (both parts) Typical Low $758.58 Median $1,071.52 Typical High $4,466.84 | Professional | None (both parts) | $758.58 | $1,071.52 | $4,466.84 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $165.96 Median $234.42 Typical High $891.25 | Professional | 26 · Professional part | $165.96 | $234.42 | $891.25 |
Cigna Setting Professional Modifier TC · Technical part Typical Low $588.84 Median $812.83 Typical High $3,548.13 | Professional | TC · Technical part | $588.84 | $812.83 | $3,548.13 |
United Setting Professional Modifier None (both parts) Typical Low $363.08 Median $912.01 Typical High $1,445.44 | Professional | None (both parts) | $363.08 | $912.01 | $1,445.44 |
United Setting Professional Modifier 26 · Professional part Typical Low $125.89 Median $204.17 Typical High $446.68 | Professional | 26 · Professional part | $125.89 | $204.17 | $446.68 |
United Setting Professional Modifier TC · Technical part Typical Low $208.93 Median $724.44 Typical High $1,148.15 | Professional | TC · Technical part | $208.93 | $724.44 | $1,148.15 |
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 $416.87 Median $416.87 Typical High $426.58 | Professional | 52 · Reduced service | $416.87 | $416.87 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $165.96 Typical High $173.78 | Professional | 53 · Discontinued | $165.96 | $165.96 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $125.89 Typical High $128.82 | Professional | 55 · Aftercare only | $125.89 | $125.89 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $83.18 Typical High $85.11 | Professional | 56 · Pre-op care only | $83.18 | $83.18 | $85.11 |
Where West Virginia sits
The same service costs 9.1 times more in Alaska than in Kentucky. 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· 39th of 51
$832
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.