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 Facility Modifier None Typical Low $691.83 Median $691.83 Typical High $912.01 | Facility | None | $691.83 | $691.83 | $912.01 |
Aetna Setting Professional Modifier None (both parts) Typical Low $467.74 Median $691.83 Typical High $691.83 | Professional | None (both parts) | $467.74 | $691.83 | $691.83 |
BCBS Alabama Setting Facility Modifier None Typical Low $588.84 Median $588.84 Typical High $588.84 | Facility | None | $588.84 | $588.84 | $588.84 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers Typical Low $371.54 Median $446.68 Typical High $446.68 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $371.54 | $446.68 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $467.74 Median $501.19 Typical High $1,905.46 | Facility | None | $467.74 | $501.19 | $1,905.46 |
Cigna Setting Professional Modifier None (both parts) Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | None (both parts) | $346.74 | $346.74 | $346.74 |
United Setting Facility Modifier None Typical Low $213.80 Median $537.03 Typical High $602.56 | Facility | None | $213.80 | $537.03 | $602.56 |
United Setting Professional Modifier None (both parts) Typical Low $251.19 Median $331.13 Typical High $354.81 | Professional | None (both parts) | $251.19 | $331.13 | $354.81 |
3 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 26 · Professional part Typical Low $467.74 Median $691.83 Typical High $691.83 | Professional | 26 · Professional part | $467.74 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $234.42 Median $346.74 Typical High $346.74 | Professional | 52 · Reduced service | $234.42 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $138.04 Typical High $138.04 | Professional | 53 · Discontinued | $93.33 | $138.04 | $138.04 |
Where Alabama sits
The same service costs 5.5 times more in Texas than in New Mexico. 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.
Alabama· 28th of 51
$589
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.