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 $489.78 Median $933.25 Typical High $1,862.09 | Facility | None | $489.78 | $933.25 | $1,862.09 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $95.50 Typical High $158.49 | Professional | None | $81.28 | $95.50 | $158.49 |
Ambetter Setting Professional Modifier None Typical Low $56.23 Median $93.33 Typical High $125.89 | Professional | None | $56.23 | $93.33 | $125.89 |
BCBS Alabama Setting Facility Modifier None Typical Low $707.95 Median $724.44 Typical High $724.44 | Facility | None | $707.95 | $724.44 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $75.86 Typical High $616.60 | Facility | None | $58.88 | $75.86 | $616.60 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $95.50 Typical High $120.23 | Professional | None | $74.13 | $95.50 | $120.23 |
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 $50.12 Median $77.62 Typical High $131.83 | Professional | None | $50.12 | $77.62 | $131.83 |
8 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 $47.86 Median $47.86 Typical High $79.43 | Professional | 52 · Reduced service | $47.86 | $47.86 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $19.05 Typical High $31.62 | Professional | 53 · Discontinued | $19.05 | $19.05 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $72.44 Typical High $117.49 | Professional | 54 · Surgery only | $72.44 | $72.44 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $14.45 Typical High $23.44 | Professional | 55 · Aftercare only | $14.45 | $14.45 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $9.55 Typical High $15.85 | Professional | 56 · Pre-op care only | $9.55 | $9.55 | $15.85 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $141.25 Median $141.25 Typical High $190.55 | Professional | 50 · Both sides | $141.25 | $141.25 | $190.55 |
BCBS Alabama Setting Facility Modifier 50 · Both sides Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Facility | 50 · Both sides | $1,071.52 | $1,071.52 | $1,071.52 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 Typical Low $46.77 Median $63.10 Typical High $83.18 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 | $46.77 | $63.10 | $83.18 |
Where Alabama sits
The same service costs 3.7 times more in Alaska than in Kentucky. 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· 34th of 51
$97.72
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.