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 $870.96 Median $870.96 Typical High $1,174.90 | Facility | None | $870.96 | $870.96 | $1,174.90 |
Aetna Setting Professional Modifier None (both parts) Typical Low $588.84 Median $870.96 Typical High $870.96 | Professional | None (both parts) | $588.84 | $870.96 | $870.96 |
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 $489.78 Median $2,238.72 Typical High $2,238.72 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $489.78 | $2,238.72 | $2,238.72 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $645.65 Typical High $2,398.83 | Facility | None | $616.60 | $645.65 | $2,398.83 |
Cigna Setting Professional Modifier None (both parts) Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | None (both parts) | $602.56 | $602.56 | $602.56 |
United Setting Facility Modifier None Typical Low $275.42 Median $691.83 Typical High $758.58 | Facility | None | $275.42 | $691.83 | $758.58 |
United Setting Professional Modifier None (both parts) Typical Low $316.23 Median $416.87 Typical High $457.09 | Professional | None (both parts) | $316.23 | $416.87 | $457.09 |
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 $588.84 Median $870.96 Typical High $870.96 | Professional | 26 · Professional part | $588.84 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $295.12 Median $436.52 Typical High $436.52 | Professional | 52 · Reduced service | $295.12 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $173.78 Typical High $173.78 | Professional | 53 · Discontinued | $117.49 | $173.78 | $173.78 |
Where Alabama sits
The same service costs 10.0 times more in Texas than in Mississippi. 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· 33rd 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.