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 $776.25 Median $1,258.93 Typical High $2,630.27 | Facility | None | $776.25 | $1,258.93 | $2,630.27 |
Aetna Setting Professional Modifier None (both parts) Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | None (both parts) | $64.57 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $26.30 Median $26.30 Typical High $26.30 | Professional | 26 · Professional part | $26.30 | $26.30 | $26.30 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | TC · Technical part | $38.02 | $38.02 | $38.02 |
BCBS Alabama Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Facility | None | $56.23 | $56.23 | $56.23 |
Cigna Setting Facility Modifier None Typical Low $31.62 Median $50.12 Typical High $56.23 | Facility | None | $31.62 | $50.12 | $56.23 |
United Setting Facility Modifier None Typical Low $43.65 Median $44.67 Typical High $60.26 | Facility | None | $43.65 | $44.67 | $60.26 |
United Setting Professional Modifier None (both parts) Typical Low $60.26 Median $72.44 Typical High $107.15 | Professional | None (both parts) | $60.26 | $72.44 | $107.15 |
United Setting Professional Modifier 26 · Professional part Typical Low $23.44 Median $29.51 Typical High $42.66 | Professional | 26 · Professional part | $23.44 | $29.51 | $42.66 |
United Setting Professional Modifier TC · Technical part Typical Low $37.15 Median $44.67 Typical High $63.10 | Professional | TC · Technical part | $37.15 | $44.67 | $63.10 |
5 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 52 · Reduced service Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | 52 · Reduced service | $32.36 | $32.36 | $32.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $12.88 Typical High $12.88 | Professional | 53 · Discontinued | $12.88 | $12.88 | $12.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | 54 · Surgery only | $48.98 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $9.77 Typical High $9.77 | Professional | 55 · Aftercare only | $9.77 | $9.77 | $9.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $6.46 Typical High $6.46 | Professional | 56 · Pre-op care only | $6.46 | $6.46 | $6.46 |
Where Alabama sits
The same service costs 4.4 times more in Texas than in New York. 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· 45th of 51
$64.57
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.