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 $50.12 Median $66.07 Typical High $66.07 | Professional | None (both parts) | $50.12 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $19.05 Median $26.30 Typical High $26.30 | Professional | 26 · Professional part | $19.05 | $26.30 | $26.30 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $31.62 Median $39.81 Typical High $39.81 | Professional | TC · Technical part | $31.62 | $39.81 | $39.81 |
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 $22.91 Median $45.71 Typical High $74.13 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $22.91 | $45.71 | $74.13 |
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 $27.54 Median $27.54 Typical High $72.44 | Professional | None (both parts) | $27.54 | $27.54 | $72.44 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $10.23 Median $10.23 Typical High $37.15 | Professional | 26 · Professional part | $10.23 | $10.23 | $37.15 |
Cigna Setting Professional Modifier TC · Technical part Typical Low $17.38 Median $17.38 Typical High $44.67 | Professional | TC · Technical part | $17.38 | $17.38 | $44.67 |
United Setting Professional Modifier None (both parts) Typical Low $41.69 Median $47.86 Typical High $75.86 | Professional | None (both parts) | $41.69 | $47.86 | $75.86 |
United Setting Professional Modifier 26 · Professional part Typical Low $16.22 Median $18.20 Typical High $27.54 | Professional | 26 · Professional part | $16.22 | $18.20 | $27.54 |
United Setting Professional Modifier TC · Technical part Typical Low $25.12 Median $30.20 Typical High $46.77 | Professional | TC · Technical part | $25.12 | $30.20 | $46.77 |
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 $7.94 Median $7.94 Typical High $10.72 | Facility | 53 · Discontinued | $7.94 | $7.94 | $10.72 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $25.12 Median $33.11 Typical High $33.11 | Professional | 52 · Reduced service | $25.12 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $13.18 Typical High $13.18 | Professional | 53 · Discontinued | $10.00 | $13.18 | $13.18 |
Where Alabama sits
The same service costs 4.4 times more in Alaska than in Texas. 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· 43rd 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.