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 $19.95 Median $19.95 Typical High $26.92 | Facility | None | $19.95 | $19.95 | $26.92 |
Aetna Setting Professional Modifier None (both parts) Typical Low $12.30 Median $19.95 Typical High $19.95 | Professional | None (both parts) | $12.30 | $19.95 | $19.95 |
BCBS Alabama Setting Facility Modifier None Typical Low $26.30 Median $26.30 Typical High $26.30 | Facility | None | $26.30 | $26.30 | $26.30 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers Typical Low $8.91 Median $10.96 Typical High $13.18 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $8.91 | $10.96 | $13.18 |
Cigna Setting Facility Modifier None Typical Low $14.13 Median $14.45 Typical High $54.95 | Facility | None | $14.13 | $14.45 | $54.95 |
Cigna Setting Professional Modifier None (both parts) Typical Low $19.95 Median $19.95 Typical High $24.55 | Professional | None (both parts) | $19.95 | $19.95 | $24.55 |
United Setting Facility Modifier None Typical Low $6.17 Median $15.49 Typical High $17.38 | Facility | None | $6.17 | $15.49 | $17.38 |
United Setting Professional Modifier None (both parts) Typical Low $7.24 Median $8.71 Typical High $10.47 | Professional | None (both parts) | $7.24 | $8.71 | $10.47 |
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 $19.95 Median $19.95 Typical High $19.95 | Professional | 26 · Professional part | $19.95 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $7.08 Median $10.00 Typical High $10.00 | Professional | 52 · Reduced service | $7.08 | $10.00 | $10.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.82 Median $3.98 Typical High $3.98 | Professional | 53 · Discontinued | $2.82 | $3.98 | $3.98 |
Where Alabama sits
The same service costs 3.3 times more in Alaska 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· 3rd of 51
$26.30
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.