How much rates vary
Facilitymedian $83 · 10th to 90th $83 to $105Professionalmedian $30 · 10th to 90th $21 to $43
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 $29.51 Median $41.69 Typical High $43.65 | Facility | None | $29.51 | $41.69 | $43.65 |
Aetna Setting Professional Modifier None (both parts) Typical Low $28.18 Median $41.69 Typical High $45.71 | Professional | None (both parts) | $28.18 | $41.69 | $45.71 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $7.24 Median $10.72 Typical High $12.30 | Professional | 26 · Professional part | $7.24 | $10.72 | $12.30 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $20.89 Median $30.20 Typical High $31.62 | Professional | TC · Technical part | $20.89 | $30.20 | $31.62 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $21.38 Median $25.12 Typical High $33.88 | Professional | None (both parts) | $21.38 | $25.12 | $33.88 |
Ambetter Setting Professional Modifier 26 · Professional part Typical Low $6.03 Median $6.03 Typical High $10.47 | Professional | 26 · Professional part | $6.03 | $6.03 | $10.47 |
Ambetter Setting Professional Modifier TC · Technical part Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | TC · Technical part | $15.14 | $15.14 | $15.14 |
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 $9.77 Median $26.92 Typical High $40.74 | Professional | 12 + 32 · Mandated service + 81 · Minimal assistant surgeon | $9.77 | $26.92 | $40.74 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $117.49 Typical High $213.80 | Facility | None | $52.48 | $117.49 | $213.80 |
Cigna Setting Professional Modifier None (both parts) Typical Low $24.55 Median $28.84 Typical High $45.71 | Professional | None (both parts) | $24.55 | $28.84 | $45.71 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $8.13 Median $9.55 Typical High $14.45 | Professional | 26 · Professional part | $8.13 | $9.55 | $14.45 |
Cigna Setting Professional Modifier TC · Technical part Typical Low $18.62 Median $19.05 Typical High $36.31 | Professional | TC · Technical part | $18.62 | $19.05 | $36.31 |
United Setting Facility Modifier None Typical Low $100.00 Median $104.71 Typical High $138.04 | Facility | None | $100.00 | $104.71 | $138.04 |
United Setting Professional Modifier None (both parts) Typical Low $21.38 Median $28.84 Typical High $37.15 | Professional | None (both parts) | $21.38 | $28.84 | $37.15 |
United Setting Professional Modifier 26 · Professional part Typical Low $6.61 Median $8.32 Typical High $11.75 | Professional | 26 · Professional part | $6.61 | $8.32 | $11.75 |
United Setting Professional Modifier TC · Technical part Typical Low $14.79 Median $20.42 Typical High $25.70 | Professional | TC · Technical part | $14.79 | $20.42 | $25.70 |
3 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 $14.13 Median $20.42 Typical High $20.42 | Professional | 52 · Reduced service | $14.13 | $20.42 | $20.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $8.32 Typical High $8.32 | Professional | 53 · Discontinued | $5.75 | $8.32 | $8.32 |
BCBS Alabama Setting Facility Modifier 50 · Both sides Typical Low $125.89 Median $125.89 Typical High $125.89 | Facility | 50 · Both sides | $125.89 | $125.89 | $125.89 |
Where Alabama sits
The same service costs 6.0 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· 35th of 51
$33.88
VT $155FL $25.70
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.