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 $776.25 Median $1,258.93 Typical High $2,630.27 | Facility | None | $776.25 | $1,258.93 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $15.49 Median $17.38 Typical High $19.95 | Professional | None | $15.49 | $17.38 | $19.95 |
BCBS Alabama Setting Facility Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Facility | None | $239.88 | $239.88 | $239.88 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 Typical Low $16.22 Median $21.88 Typical High $23.99 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 | $16.22 | $21.88 | $23.99 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $446.68 Typical High $977.24 | Facility | None | $50.12 | $446.68 | $977.24 |
Cigna Setting Professional Modifier None Typical Low $14.13 Median $15.85 Typical High $17.78 | Professional | None | $14.13 | $15.85 | $17.78 |
United Setting Facility Modifier None Typical Low $100.00 Median $371.54 Typical High $1,380.38 | Facility | None | $100.00 | $371.54 | $1,380.38 |
United Setting Professional Modifier None Typical Low $13.49 Median $16.22 Typical High $23.99 | Professional | None | $13.49 | $16.22 | $23.99 |
6 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 $7.76 Median $7.94 Typical High $8.71 | Professional | 52 · Reduced service | $7.76 | $7.94 | $8.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.09 Median $3.16 Typical High $3.55 | Professional | 53 · Discontinued | $3.09 | $3.16 | $3.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $11.48 Median $11.75 Typical High $13.18 | Professional | 54 · Surgery only | $11.48 | $11.75 | $13.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.29 Median $2.40 Typical High $2.63 | Professional | 55 · Aftercare only | $2.29 | $2.40 | $2.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.55 Median $1.58 Typical High $1.78 | Professional | 56 · Pre-op care only | $1.55 | $1.58 | $1.78 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $16.60 Median $16.60 Typical High $16.60 | Professional | 59 · Distinct service | $16.60 | $16.60 | $16.60 |
Where Alabama sits
The same service costs 3.9 times more in Alaska than in New Jersey. 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· 45th of 51
$17.78
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.