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 $81.28 Median $489.78 Typical High $1,737.80 | Facility | None | $81.28 | $489.78 | $1,737.80 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $120.23 Typical High $245.47 | Professional | None | $69.18 | $120.23 | $245.47 |
Ambetter Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | None | $38.02 | $38.02 | $38.02 |
BCBS Alabama Setting Facility Modifier None Typical Low $436.52 Median $446.68 Typical High $446.68 | Facility | None | $436.52 | $446.68 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $131.83 Typical High $199.53 | Professional | None | $63.10 | $131.83 | $199.53 |
United Setting Facility Modifier None Typical Low $251.19 Median $870.96 Typical High $1,737.80 | Facility | None | $251.19 | $870.96 | $1,737.80 |
United Setting Professional Modifier None Typical Low $45.71 Median $128.82 Typical High $190.55 | Professional | None | $45.71 | $128.82 | $190.55 |
7 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 $40.74 Median $54.95 Typical High $123.03 | Professional | 52 · Reduced service | $40.74 | $54.95 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $21.88 Typical High $48.98 | Professional | 53 · Discontinued | $16.22 | $21.88 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $81.28 Typical High $186.21 | Professional | 54 · Surgery only | $60.26 | $81.28 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $16.60 Typical High $37.15 | Professional | 55 · Aftercare only | $12.30 | $16.60 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $10.96 Typical High $24.55 | Professional | 56 · Pre-op care only | $8.13 | $10.96 | $24.55 |
BCBS Alabama Setting Facility Modifier 50 · Both sides Typical Low $660.69 Median $660.69 Typical High $660.69 | Facility | 50 · Both sides | $660.69 | $660.69 | $660.69 |
BCBS Alabama Setting Professional Modifier 32 · Mandated service Typical Low $114.82 Median $154.88 Typical High $181.97 | Professional | 32 · Mandated service | $114.82 | $154.88 | $181.97 |
Where Alabama sits
The same service costs 3.9 times more in Alaska than in Virginia. 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· 26th of 51
$145
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.