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 $131.83 Median $131.83 Typical High $177.83 | Facility | None | $131.83 | $131.83 | $177.83 |
Aetna Setting Professional Modifier None (both parts) Typical Low $93.33 Median $131.83 Typical High $131.83 | Professional | None (both parts) | $93.33 | $131.83 | $131.83 |
BCBS Alabama Setting Facility Modifier None Typical Low $158.49 Median $162.18 Typical High $162.18 | Facility | None | $158.49 | $162.18 | $162.18 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers Typical Low $72.44 Median $74.13 Typical High $83.18 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $72.44 | $74.13 | $83.18 |
Cigna Setting Facility Modifier None Typical Low $93.33 Median $97.72 Typical High $363.08 | Facility | None | $93.33 | $97.72 | $363.08 |
Cigna Setting Professional Modifier None (both parts) Typical Low $131.83 Median $131.83 Typical High $165.96 | Professional | None (both parts) | $131.83 | $131.83 | $165.96 |
United Setting Professional Modifier None (both parts) Typical Low $47.86 Median $57.54 Typical High $69.18 | Professional | None (both parts) | $47.86 | $57.54 | $69.18 |
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 $131.83 Median $131.83 Typical High $131.83 | Professional | 26 · Professional part | $131.83 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $46.77 Median $66.07 Typical High $66.07 | Professional | 52 · Reduced service | $46.77 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $26.30 Typical High $26.30 | Professional | 53 · Discontinued | $18.62 | $26.30 | $26.30 |
Where Alabama sits
The same service costs 8.1 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.
Alabama· 4th of 51
$158
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.