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 $147.91 Median $1,096.48 Typical High $1,905.46 | Facility | None | $147.91 | $1,096.48 | $1,905.46 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $134.90 Typical High $151.36 | Professional | None | $91.20 | $134.90 | $151.36 |
Ambetter Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | None | $74.13 | $74.13 | $74.13 |
BCBS Alabama Setting Facility Modifier None Typical Low $2,818.38 Median $2,884.03 Typical High $2,884.03 | Facility | None | $2,818.38 | $2,884.03 | $2,884.03 |
Cigna Setting Facility Modifier None Typical Low $89.13 Median $112.20 Typical High $630.96 | Facility | None | $89.13 | $112.20 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $112.20 Typical High $141.25 | Professional | None | $93.33 | $112.20 | $141.25 |
United Setting Facility Modifier None Typical Low $478.63 Median $1,000.00 Typical High $3,162.28 | Facility | None | $478.63 | $1,000.00 | $3,162.28 |
United Setting Professional Modifier None Typical Low $79.43 Median $125.89 Typical High $181.97 | Professional | None | $79.43 | $125.89 | $181.97 |
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 $45.71 Median $58.88 Typical High $74.13 | Professional | 52 · Reduced service | $45.71 | $58.88 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $23.44 Typical High $30.20 | Professional | 53 · Discontinued | $18.20 | $23.44 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $89.13 Typical High $112.20 | Professional | 54 · Surgery only | $67.61 | $89.13 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $17.78 Typical High $22.39 | Professional | 55 · Aftercare only | $13.49 | $17.78 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $11.75 Typical High $14.79 | Professional | 56 · Pre-op care only | $9.12 | $11.75 | $14.79 |
BCBS Alabama Setting Professional Modifier 32 · Mandated service Typical Low $100.00 Median $138.04 Typical High $213.80 | Professional | 32 · Mandated service | $100.00 | $138.04 | $213.80 |
Where Alabama sits
The same service costs 3.2 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· 43rd of 51
$148
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.