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 Typical Low $43.65 Median $57.54 Typical High $75.86 | Professional | None | $43.65 | $57.54 | $75.86 |
Ambetter Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | None | $77.62 | $77.62 | $77.62 |
BCBS Alabama Setting Facility Modifier None Typical Low $269.15 Median $275.42 Typical High $275.42 | Facility | None | $269.15 | $275.42 | $275.42 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 Typical Low $34.67 Median $47.86 Typical High $61.66 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 | $34.67 | $47.86 | $61.66 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $102.33 Typical High $512.86 | Facility | None | $50.12 | $102.33 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $52.48 Typical High $64.57 | Professional | None | $43.65 | $52.48 | $64.57 |
United Setting Facility Modifier None Typical Low $100.00 Median $363.08 Typical High $1,380.38 | Facility | None | $100.00 | $363.08 | $1,380.38 |
United Setting Professional Modifier None Typical Low $38.02 Median $57.54 Typical High $79.43 | Professional | None | $38.02 | $57.54 | $79.43 |
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 $21.88 Median $27.54 Typical High $38.02 | Professional | 52 · Reduced service | $21.88 | $27.54 | $38.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $10.96 Typical High $15.14 | Professional | 53 · Discontinued | $8.71 | $10.96 | $15.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $8.32 Typical High $11.22 | Professional | 55 · Aftercare only | $6.61 | $8.32 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $5.50 Typical High $7.59 | Professional | 56 · Pre-op care only | $4.37 | $5.50 | $7.59 |
Where Alabama sits
The same service costs 3.3 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
$64.57
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.