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 $85.11 Median $95.50 Typical High $95.50 | Facility | None | $85.11 | $95.50 | $95.50 |
Aetna Setting Professional Modifier None (both parts) Typical Low $60.26 Median $95.50 Typical High $95.50 | Professional | None (both parts) | $60.26 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $18.20 Median $28.84 Typical High $28.84 | Professional | 26 · Professional part | $18.20 | $28.84 | $28.84 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $40.74 Median $67.61 Typical High $67.61 | Professional | TC · Technical part | $40.74 | $67.61 | $67.61 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | None (both parts) | $42.66 | $42.66 | $42.66 |
BCBS Alabama Setting Facility Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Facility | None | $58.88 | $58.88 | $58.88 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers Typical Low $28.84 Median $57.54 Typical High $87.10 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $28.84 | $57.54 | $87.10 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $56.23 Typical High $213.80 | Facility | None | $52.48 | $56.23 | $213.80 |
Cigna Setting Professional Modifier None (both parts) Typical Low $30.90 Median $30.90 Typical High $79.43 | Professional | None (both parts) | $30.90 | $30.90 | $79.43 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $10.47 Median $10.47 Typical High $38.02 | Professional | 26 · Professional part | $10.47 | $10.47 | $38.02 |
Cigna Setting Professional Modifier TC · Technical part Typical Low $20.42 Median $20.42 Typical High $52.48 | Professional | TC · Technical part | $20.42 | $20.42 | $52.48 |
United Setting Professional Modifier None (both parts) Typical Low $50.12 Median $53.70 Typical High $93.33 | Professional | None (both parts) | $50.12 | $53.70 | $93.33 |
United Setting Professional Modifier 26 · Professional part Typical Low $16.98 Median $18.62 Typical High $29.51 | Professional | 26 · Professional part | $16.98 | $18.62 | $29.51 |
United Setting Professional Modifier TC · Technical part Typical Low $33.11 Median $35.48 Typical High $64.57 | Professional | TC · Technical part | $33.11 | $35.48 | $64.57 |
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 $31.62 Median $47.86 Typical High $47.86 | Professional | 52 · Reduced service | $31.62 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $19.05 Typical High $19.05 | Professional | 53 · Discontinued | $12.59 | $19.05 | $19.05 |
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
$58.88
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.