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 $48.98 Median $48.98 Typical High $48.98 | Professional | None (both parts) | $48.98 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | 26 · Professional part | $20.42 | $20.42 | $20.42 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | TC · Technical part | $28.84 | $28.84 | $28.84 |
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 $41.69 Median $50.12 Typical High $72.44 | Professional | None (both parts) | $41.69 | $50.12 | $72.44 |
United Setting Professional Modifier 26 · Professional part Typical Low $15.85 Median $19.95 Typical High $28.84 | Professional | 26 · Professional part | $15.85 | $19.95 | $28.84 |
United Setting Professional Modifier TC · Technical part Typical Low $25.12 Median $30.20 Typical High $42.66 | Professional | TC · Technical part | $25.12 | $30.20 | $42.66 |
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 $24.55 Median $24.55 Typical High $24.55 | Professional | 52 · Reduced service | $24.55 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $9.77 Typical High $9.77 | Professional | 53 · Discontinued | $9.77 | $9.77 | $9.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | 54 · Surgery only | $37.15 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $7.41 Typical High $7.41 | Professional | 55 · Aftercare only | $7.41 | $7.41 | $7.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $4.90 Typical High $4.90 | Professional | 56 · Pre-op care only | $4.90 | $4.90 | $4.90 |
Where Alabama sits
The same service costs 3.3 times more in Nebraska 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· 43rd of 51
$48.98
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.