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 $562.34 Median $954.99 Typical High $2,398.83 | Facility | None | $562.34 | $954.99 | $2,398.83 |
Aetna Setting Professional Modifier None Typical Low $2.00 Median $5.50 Typical High $6.76 | Professional | None | $2.00 | $5.50 | $6.76 |
Ambetter Setting Professional Modifier None Typical Low $2.88 Median $5.75 Typical High $6.46 | Professional | None | $2.88 | $5.75 | $6.46 |
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 $2.40 Median $3.39 Typical High $4.68 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 | $2.40 | $3.39 | $4.68 |
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 $2.24 Median $4.17 Typical High $8.91 | Professional | None | $2.24 | $4.17 | $8.91 |
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 $1.74 Median $4.57 Typical High $8.51 | Professional | None | $1.74 | $4.57 | $8.51 |
5 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 $1.00 Median $1.95 Typical High $3.09 | Professional | 52 · Reduced service | $1.00 | $1.95 | $3.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.40 Median $0.78 Typical High $1.23 | Professional | 53 · Discontinued | $0.40 | $0.78 | $1.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1.48 Median $2.95 Typical High $4.68 | Professional | 54 · Surgery only | $1.48 | $2.95 | $4.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.30 Median $0.58 Typical High $0.93 | Professional | 55 · Aftercare only | $0.30 | $0.58 | $0.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.20 Median $0.39 Typical High $0.62 | Professional | 56 · Pre-op care only | $0.20 | $0.39 | $0.62 |
Where Alabama sits
The same service costs 3.0 times more in Alaska than in Nebraska. 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
$5.62
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.