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 $154.88 Median $154.88 Typical High $162.18 | Facility | TC · Technical part | $154.88 | $154.88 | $162.18 |
Aetna Setting Professional Modifier None (both parts) Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | None (both parts) | $223.87 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | 26 · Professional part | $67.61 | $67.61 | $67.61 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | TC · Technical part | $154.88 | $154.88 | $154.88 |
BCBS Alabama Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
BCBS Alabama Setting Professional Modifier None (both parts) Typical Low $36.31 Median $109.65 Typical High $151.36 | Professional | None (both parts) | $36.31 | $109.65 | $151.36 |
Cigna Setting Facility Modifier None Typical Low $117.49 Median $208.93 Typical High $234.42 | Facility | None | $117.49 | $208.93 | $234.42 |
Cigna Setting Professional Modifier None (both parts) Typical Low $190.55 Median $223.87 Typical High $257.04 | Professional | None (both parts) | $190.55 | $223.87 | $257.04 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $45.71 Median $53.70 Typical High $61.66 | Professional | 26 · Professional part | $45.71 | $53.70 | $61.66 |
Cigna Setting Professional Modifier TC · Technical part Typical Low $144.54 Median $169.82 Typical High $199.53 | Professional | TC · Technical part | $144.54 | $169.82 | $199.53 |
United Setting Facility Modifier None Typical Low $147.91 Median $154.88 Typical High $204.17 | Facility | None | $147.91 | $154.88 | $204.17 |
United Setting Professional Modifier None (both parts) Typical Low $109.65 Median $131.83 Typical High $295.12 | Professional | None (both parts) | $109.65 | $131.83 | $295.12 |
United Setting Professional Modifier 26 · Professional part Typical Low $28.84 Median $36.31 Typical High $52.48 | Professional | 26 · Professional part | $28.84 | $36.31 | $52.48 |
United Setting Professional Modifier TC · Technical part Typical Low $79.43 Median $95.50 Typical High $257.04 | Professional | TC · Technical part | $79.43 | $95.50 | $257.04 |
4 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 $112.20 Median $112.20 Typical High $112.20 | Professional | 52 · Reduced service | $112.20 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | 53 · Discontinued | $44.67 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | 55 · Aftercare only | $33.11 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | 56 · Pre-op care only | $22.39 | $22.39 | $22.39 |
Where Alabama sits
The same service costs 3.2 times more in Kansas than in Utah. 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· 48th of 51
$115
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.