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 $446.68 Median $1,258.93 Typical High $2,398.83 | Facility | None | $446.68 | $1,258.93 | $2,398.83 |
Aetna Setting Professional Modifier None (both parts) Typical Low $275.42 Median $446.68 Typical High $446.68 | Professional | None (both parts) | $275.42 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $95.50 Median $165.96 Typical High $169.82 | Professional | 26 · Professional part | $95.50 | $165.96 | $169.82 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $181.97 Median $288.40 Typical High $288.40 | Professional | TC · Technical part | $181.97 | $288.40 | $288.40 |
Ambetter Setting Professional Modifier 26 · Professional part Typical Low $89.13 Median $117.49 Typical High $257.04 | Professional | 26 · Professional part | $89.13 | $117.49 | $257.04 |
BCBS Alabama Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Facility | None | $263.03 | $263.03 | $263.03 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery Typical Low $57.54 Median $89.13 Typical High $181.97 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery | $57.54 | $89.13 | $181.97 |
Cigna Setting Professional Modifier None (both parts) Typical Low $331.13 Median $389.05 Typical High $489.78 | Professional | None (both parts) | $331.13 | $389.05 | $489.78 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $117.49 Median $138.04 Typical High $173.78 | Professional | 26 · Professional part | $117.49 | $138.04 | $173.78 |
Cigna Setting Professional Modifier TC · Technical part Typical Low $208.93 Median $245.47 Typical High $316.23 | Professional | TC · Technical part | $208.93 | $245.47 | $316.23 |
United Setting Facility Modifier None Typical Low $100.00 Median $323.59 Typical High $1,380.38 | Facility | None | $100.00 | $323.59 | $1,380.38 |
United Setting Professional Modifier None (both parts) Typical Low $218.78 Median $275.42 Typical High $380.19 | Professional | None (both parts) | $218.78 | $275.42 | $380.19 |
United Setting Professional Modifier 26 · Professional part Typical Low $74.13 Median $93.33 Typical High $134.90 | Professional | 26 · Professional part | $74.13 | $93.33 | $134.90 |
United Setting Professional Modifier TC · Technical part Typical Low $144.54 Median $181.97 Typical High $245.47 | Professional | TC · Technical part | $144.54 | $181.97 | $245.47 |
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 $223.87 Median $223.87 Typical High $223.87 | Professional | 52 · Reduced service | $223.87 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | 53 · Discontinued | $89.13 | $89.13 | $89.13 |
Where Alabama sits
The same service costs 6.5 times more in Wisconsin than in Hawaii. 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· 42nd of 51
$288
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.