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 $57.54 Median $67.61 Typical High $100.00 | Facility | None | $57.54 | $67.61 | $100.00 |
Aetna Setting Professional Modifier None (both parts) Typical Low $42.66 Median $67.61 Typical High $89.13 | Professional | None (both parts) | $42.66 | $67.61 | $89.13 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $17.38 Median $28.18 Typical High $41.69 | Professional | 26 · Professional part | $17.38 | $28.18 | $41.69 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $24.55 Median $39.81 Typical High $40.74 | Professional | TC · Technical part | $24.55 | $39.81 | $40.74 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $29.51 Median $29.51 Typical High $29.51 | Professional | None (both parts) | $29.51 | $29.51 | $29.51 |
BCBS Alabama Setting Facility Modifier None Typical Low $41.69 Median $42.66 Typical High $42.66 | Facility | None | $41.69 | $42.66 | $42.66 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers Typical Low $35.48 Median $54.95 Typical High $102.33 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $35.48 | $54.95 | $102.33 |
Cigna Setting Facility Modifier None Typical Low $32.36 Median $33.88 Typical High $125.89 | Facility | None | $32.36 | $33.88 | $125.89 |
Cigna Setting Professional Modifier None (both parts) Typical Low $29.51 Median $29.51 Typical High $117.49 | Professional | None (both parts) | $29.51 | $29.51 | $117.49 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $13.80 Median $13.80 Typical High $70.79 | Professional | 26 · Professional part | $13.80 | $13.80 | $70.79 |
Cigna Setting Professional Modifier TC · Technical part Typical Low $15.85 Median $15.85 Typical High $47.86 | Professional | TC · Technical part | $15.85 | $15.85 | $47.86 |
United Setting Facility Modifier None Typical Low $60.26 Median $63.10 Typical High $83.18 | Facility | None | $60.26 | $63.10 | $83.18 |
United Setting Professional Modifier None (both parts) Typical Low $38.02 Median $69.18 Typical High $109.65 | Professional | None (both parts) | $38.02 | $69.18 | $109.65 |
United Setting Professional Modifier 26 · Professional part Typical Low $16.60 Median $28.84 Typical High $52.48 | Professional | 26 · Professional part | $16.60 | $28.84 | $52.48 |
United Setting Professional Modifier TC · Technical part Typical Low $21.38 Median $39.81 Typical High $43.65 | Professional | TC · Technical part | $21.38 | $39.81 | $43.65 |
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 $24.55 Median $33.88 Typical High $33.88 | Professional | 52 · Reduced service | $24.55 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $13.49 Typical High $13.49 | Professional | 53 · Discontinued | $9.77 | $13.49 | $13.49 |
Where Alabama sits
The same service costs 3.6 times more in Wisconsin 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
$42.66
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.