How much rates vary
Facilitymedian $83 · 10th to 90th $83 to $141Professionalmedian $36 · 10th to 90th $28 to $52
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 $36.31 Median $50.12 Typical High $190.55 | Facility | None | $36.31 | $50.12 | $190.55 |
Aetna Setting Professional Modifier None (both parts) Typical Low $36.31 Median $50.12 Typical High $57.54 | Professional | None (both parts) | $36.31 | $50.12 | $57.54 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $10.00 Median $14.45 Typical High $16.60 | Professional | 26 · Professional part | $10.00 | $14.45 | $16.60 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $25.70 Median $35.48 Typical High $40.74 | Professional | TC · Technical part | $25.70 | $35.48 | $40.74 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $24.55 Median $30.90 Typical High $48.98 | Professional | None (both parts) | $24.55 | $30.90 | $48.98 |
Ambetter Setting Professional Modifier 26 · Professional part Typical Low $8.13 Median $8.13 Typical High $14.45 | Professional | 26 · Professional part | $8.13 | $8.13 | $14.45 |
Ambetter Setting Professional Modifier TC · Technical part Typical Low $17.78 Median $20.89 Typical High $34.67 | Professional | TC · Technical part | $17.78 | $20.89 | $34.67 |
BCBS Alabama Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Facility | None | $83.18 | $83.18 | $83.18 |
BCBS Alabama Setting Professional Modifier 12 + 32 · Mandated service + 81 · Minimal assistant surgeon Typical Low $13.18 Median $38.02 Typical High $56.23 | Professional | 12 + 32 · Mandated service + 81 · Minimal assistant surgeon | $13.18 | $38.02 | $56.23 |
Cigna Setting Facility Modifier None Typical Low $95.50 Median $141.25 Typical High $257.04 | Facility | None | $95.50 | $141.25 | $257.04 |
Cigna Setting Professional Modifier None (both parts) Typical Low $30.90 Median $36.31 Typical High $58.88 | Professional | None (both parts) | $30.90 | $36.31 | $58.88 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $10.96 Median $12.88 Typical High $19.50 | Professional | 26 · Professional part | $10.96 | $12.88 | $19.50 |
Cigna Setting Professional Modifier TC · Technical part Typical Low $23.44 Median $23.44 Typical High $44.67 | Professional | TC · Technical part | $23.44 | $23.44 | $44.67 |
United Setting Facility Modifier None Typical Low $120.23 Median $125.89 Typical High $165.96 | Facility | None | $120.23 | $125.89 | $165.96 |
United Setting Professional Modifier None (both parts) Typical Low $28.18 Median $35.48 Typical High $47.86 | Professional | None (both parts) | $28.18 | $35.48 | $47.86 |
United Setting Professional Modifier 26 · Professional part Typical Low $8.71 Median $10.96 Typical High $15.85 | Professional | 26 · Professional part | $8.71 | $10.96 | $15.85 |
United Setting Professional Modifier TC · Technical part Typical Low $19.05 Median $23.99 Typical High $34.67 | Professional | TC · Technical part | $19.05 | $23.99 | $34.67 |
6 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 $18.20 Median $25.12 Typical High $25.12 | Professional | 52 · Reduced service | $18.20 | $25.12 | $25.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.24 Median $10.00 Typical High $10.00 | Professional | 53 · Discontinued | $7.24 | $10.00 | $10.00 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $26.30 Median $28.84 Typical High $30.90 | Professional | 59 · Distinct service | $26.30 | $28.84 | $30.90 |
Ambetter Setting Professional Modifier FY · Cassette-based X-ray Typical Low $26.30 Median $30.90 Typical High $30.90 | Professional | FY · Cassette-based X-ray | $26.30 | $30.90 | $30.90 |
Ambetter Setting Professional Modifier GY · Excluded by law Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | GY · Excluded by law | $28.84 | $28.84 | $28.84 |
Ambetter Setting Professional Modifier XU · Unusual separate service Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | XU · Unusual separate service | $28.84 | $28.84 | $28.84 |
Where Alabama sits
The same service costs 12.6 times more in Vermont than in Florida. 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· 40th of 51
$39.81
VT $389FL $30.90
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.