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 $537.03 Median $537.03 Typical High $707.95 | Facility | None | $537.03 | $537.03 | $707.95 |
Aetna Setting Professional Modifier None (both parts) Typical Low $275.42 Median $331.13 Typical High $398.11 | Professional | None (both parts) | $275.42 | $331.13 | $398.11 |
BCBS Alabama Setting Facility Modifier None Typical Low $43.65 Median $44.67 Typical High $44.67 | Facility | None | $43.65 | $44.67 | $44.67 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers Typical Low $2.19 Median $4.37 Typical High $302.00 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $2.19 | $4.37 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $389.05 Typical High $1,479.11 | Facility | None | $380.19 | $389.05 | $1,479.11 |
Cigna Setting Professional Modifier None (both parts) Typical Low $537.03 Median $537.03 Typical High $660.69 | Professional | None (both parts) | $537.03 | $537.03 | $660.69 |
United Setting Facility Modifier None Typical Low $165.96 Median $416.87 Typical High $467.74 | Facility | None | $165.96 | $416.87 | $467.74 |
United Setting Professional Modifier None (both parts) Typical Low $194.98 Median $234.42 Typical High $275.42 | Professional | None (both parts) | $194.98 | $234.42 | $275.42 |
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 $537.03 Median $537.03 Typical High $537.03 | Professional | 26 · Professional part | $537.03 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $190.55 Median $269.15 Typical High $269.15 | Professional | 52 · Reduced service | $190.55 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $107.15 Typical High $107.15 | Professional | 53 · Discontinued | $75.86 | $107.15 | $107.15 |
Where Alabama sits
The same service costs 309.0 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.
Alabama· 50th of 51
$44.67
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.