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 Professional Modifier None (both parts) Typical Low $125.89 Median $173.78 Typical High $173.78 | Professional | None (both parts) | $125.89 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $32.36 Median $44.67 Typical High $69.18 | Professional | 26 · Professional part | $32.36 | $44.67 | $69.18 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $93.33 Median $128.82 Typical High $128.82 | Professional | TC · Technical part | $93.33 | $128.82 | $128.82 |
Ambetter Setting Professional Modifier 26 · Professional part Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | 26 · Professional part | $53.70 | $53.70 | $53.70 |
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 $47.86 Median $131.83 Typical High $177.83 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $47.86 | $131.83 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $104.71 Median $109.65 Typical High $407.38 | Facility | None | $104.71 | $109.65 | $407.38 |
Cigna Setting Professional Modifier None (both parts) Typical Low $70.79 Median $70.79 Typical High $181.97 | Professional | None (both parts) | $70.79 | $70.79 | $181.97 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $21.38 Median $21.38 Typical High $100.00 | Professional | 26 · Professional part | $21.38 | $21.38 | $100.00 |
Cigna Setting Professional Modifier TC · Technical part Typical Low $48.98 Median $48.98 Typical High $114.82 | Professional | TC · Technical part | $48.98 | $48.98 | $114.82 |
United Setting Facility Modifier None Typical Low $199.53 Median $204.17 Typical High $275.42 | Facility | None | $199.53 | $204.17 | $275.42 |
United Setting Professional Modifier None (both parts) Typical Low $97.72 Median $109.65 Typical High $181.97 | Professional | None (both parts) | $97.72 | $109.65 | $181.97 |
United Setting Professional Modifier 26 · Professional part Typical Low $26.30 Median $33.88 Typical High $57.54 | Professional | 26 · Professional part | $26.30 | $33.88 | $57.54 |
United Setting Professional Modifier TC · Technical part Typical Low $44.67 Median $75.86 Typical High $138.04 | Professional | TC · Technical part | $44.67 | $75.86 | $138.04 |
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 Facility Modifier 53 · Discontinued Typical Low $25.70 Median $25.70 Typical High $34.67 | Facility | 53 · Discontinued | $25.70 | $25.70 | $34.67 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $66.07 Median $87.10 Typical High $87.10 | Professional | 52 · Reduced service | $66.07 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $34.67 Typical High $34.67 | Professional | 53 · Discontinued | $26.30 | $34.67 | $34.67 |
Where Alabama sits
The same service costs 4.9 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
$95.50
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.