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 Professional Modifier None (both parts) Typical Low $102.33 Median $131.83 Typical High $131.83 | Professional | None (both parts) | $102.33 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $48.98 Median $69.18 Typical High $69.18 | Professional | 26 · Professional part | $48.98 | $69.18 | $69.18 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $51.29 Median $61.66 Typical High $61.66 | Professional | TC · Technical part | $51.29 | $61.66 | $61.66 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $63.10 Median $95.50 Typical High $107.15 | Professional | None (both parts) | $63.10 | $95.50 | $107.15 |
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 |
BCBS Alabama Setting Professional Modifier None (both parts) Typical Low $25.70 Median $39.81 Typical High $74.13 | Professional | None (both parts) | $25.70 | $39.81 | $74.13 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $64.57 Typical High $501.19 | Facility | None | $51.29 | $64.57 | $501.19 |
Cigna Setting Professional Modifier None (both parts) Typical Low $100.00 Median $117.49 Typical High $134.90 | Professional | None (both parts) | $100.00 | $117.49 | $134.90 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $54.95 Median $64.57 Typical High $74.13 | Professional | 26 · Professional part | $54.95 | $64.57 | $74.13 |
Cigna Setting Professional Modifier TC · Technical part Typical Low $44.67 Median $52.48 Typical High $63.10 | Professional | TC · Technical part | $44.67 | $52.48 | $63.10 |
United Setting Facility Modifier None Typical Low $100.00 Median $371.54 Typical High $1,380.38 | Facility | None | $100.00 | $371.54 | $1,380.38 |
United Setting Professional Modifier None (both parts) Typical Low $64.57 Median $81.28 Typical High $134.90 | Professional | None (both parts) | $64.57 | $81.28 | $134.90 |
United Setting Professional Modifier 26 · Professional part Typical Low $36.31 Median $45.71 Typical High $72.44 | Professional | 26 · Professional part | $36.31 | $45.71 | $72.44 |
United Setting Professional Modifier TC · Technical part Typical Low $26.92 Median $35.48 Typical High $61.66 | Professional | TC · Technical part | $26.92 | $35.48 | $61.66 |
4 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 $66.07 Median $66.07 Typical High $66.07 | Professional | 52 · Reduced service | $66.07 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $26.30 Typical High $26.30 | Professional | 53 · Discontinued | $26.30 | $26.30 | $26.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | 55 · Aftercare only | $19.50 | $19.50 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $13.18 Typical High $13.18 | Professional | 56 · Pre-op care only | $13.18 | $13.18 | $13.18 |
Where Alabama sits
The same service costs 5.9 times more in Alaska than in Alabama. 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· 51st of 51
$56.23
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.