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 $251.19 Median $426.58 Typical High $776.25 | Facility | None | $251.19 | $426.58 | $776.25 |
Aetna Setting Professional Modifier None (both parts) Typical Low $275.42 Median $363.08 Typical High $457.09 | Professional | None (both parts) | $275.42 | $363.08 | $457.09 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $85.11 Median $123.03 Typical High $141.25 | Professional | 26 · Professional part | $85.11 | $123.03 | $141.25 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $218.78 Median $239.88 Typical High $338.84 | Professional | TC · Technical part | $218.78 | $239.88 | $338.84 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $199.53 Median $199.53 Typical High $426.58 | Professional | None (both parts) | $199.53 | $199.53 | $426.58 |
Ambetter Setting Professional Modifier 26 · Professional part Typical Low $63.10 Median $79.43 Typical High $109.65 | Professional | 26 · Professional part | $63.10 | $79.43 | $109.65 |
BCBS Alabama Setting Facility Modifier None Typical Low $562.34 Median $562.34 Typical High $562.34 | Facility | None | $562.34 | $562.34 | $562.34 |
BCBS Alabama Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $100.00 Median $158.49 Typical High $316.23 | Professional | 81 · Minimal assistant surgeon | $100.00 | $158.49 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $467.74 | Facility | None | $389.05 | $389.05 | $467.74 |
Cigna Setting Professional Modifier None (both parts) Typical Low $288.40 Median $316.23 Typical High $616.60 | Professional | None (both parts) | $288.40 | $316.23 | $616.60 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $87.10 Median $102.33 Typical High $158.49 | Professional | 26 · Professional part | $87.10 | $102.33 | $158.49 |
Cigna Setting Professional Modifier TC · Technical part Typical Low $199.53 Median $213.80 Typical High $489.78 | Professional | TC · Technical part | $199.53 | $213.80 | $489.78 |
United Setting Facility Modifier None Typical Low $204.17 Median $213.80 Typical High $281.84 | Facility | None | $204.17 | $213.80 | $281.84 |
United Setting Professional Modifier None (both parts) Typical Low $234.42 Median $338.84 Typical High $645.65 | Professional | None (both parts) | $234.42 | $338.84 | $645.65 |
United Setting Professional Modifier 26 · Professional part Typical Low $70.79 Median $89.13 Typical High $128.82 | Professional | 26 · Professional part | $70.79 | $89.13 | $128.82 |
United Setting Professional Modifier TC · Technical part Typical Low $165.96 Median $245.47 Typical High $524.81 | Professional | TC · Technical part | $165.96 | $245.47 | $524.81 |
2 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 $138.04 Median $181.97 Typical High $181.97 | Professional | 52 · Reduced service | $138.04 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $72.44 Typical High $72.44 | Professional | 53 · Discontinued | $56.23 | $72.44 | $72.44 |
Where Alabama sits
The same service costs 12.3 times more in Vermont than in Utah. 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· 34th of 51
$363
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.