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 TC · Technical part Typical Low $93.33 Median $93.33 Typical High $125.89 | Facility | TC · Technical part | $93.33 | $93.33 | $125.89 |
Aetna Setting Professional Modifier None (both parts) Typical Low $87.10 Median $128.82 Typical High $128.82 | Professional | None (both parts) | $87.10 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $23.44 Median $34.67 Typical High $34.67 | Professional | 26 · Professional part | $23.44 | $34.67 | $34.67 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $64.57 Median $93.33 Typical High $93.33 | Professional | TC · Technical part | $64.57 | $93.33 | $93.33 |
Ambetter Setting Professional Modifier 26 · Professional part Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | 26 · Professional part | $41.69 | $41.69 | $41.69 |
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 $69.18 Typical High $123.03 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $28.84 | $69.18 | $123.03 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $79.43 Typical High $295.12 | Facility | None | $75.86 | $79.43 | $295.12 |
Cigna Setting Professional Modifier None (both parts) Typical Low $43.65 Median $43.65 Typical High $125.89 | Professional | None (both parts) | $43.65 | $43.65 | $125.89 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $13.18 Median $13.18 Typical High $54.95 | Professional | 26 · Professional part | $13.18 | $13.18 | $54.95 |
Cigna Setting Professional Modifier TC · Technical part Typical Low $30.90 Median $30.90 Typical High $112.20 | Professional | TC · Technical part | $30.90 | $30.90 | $112.20 |
United Setting Professional Modifier None (both parts) Typical Low $72.44 Median $77.62 Typical High $141.25 | Professional | None (both parts) | $72.44 | $77.62 | $141.25 |
United Setting Professional Modifier 26 · Professional part Typical Low $19.95 Median $21.88 Typical High $36.31 | Professional | 26 · Professional part | $19.95 | $21.88 | $36.31 |
United Setting Professional Modifier TC · Technical part Typical Low $50.12 Median $56.23 Typical High $104.71 | Professional | TC · Technical part | $50.12 | $56.23 | $104.71 |
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 $50.12 Median $64.57 Typical High $64.57 | Professional | 52 · Reduced service | $50.12 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $25.70 Typical High $25.70 | Professional | 53 · Discontinued | $19.95 | $25.70 | $25.70 |
Where Alabama sits
The same service costs 5.5 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
$69.18
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.