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 $107.15 Median $776.25 Typical High $1,862.09 | Facility | None | $107.15 | $776.25 | $1,862.09 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $147.91 Typical High $295.12 | Professional | None | $85.11 | $147.91 | $295.12 |
Ambetter Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | None | $64.57 | $64.57 | $64.57 |
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 $83.18 Median $158.49 Typical High $239.88 | Professional | None | $83.18 | $158.49 | $239.88 |
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 $61.66 Median $151.36 Typical High $263.03 | Professional | None | $61.66 | $151.36 | $263.03 |
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 $53.70 Median $72.44 Typical High $144.54 | Professional | 52 · Reduced service | $53.70 | $72.44 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $28.84 Typical High $58.88 | Professional | 53 · Discontinued | $21.38 | $28.84 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $109.65 Typical High $218.78 | Professional | 54 · Surgery only | $81.28 | $109.65 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $21.88 Typical High $43.65 | Professional | 55 · Aftercare only | $16.22 | $21.88 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $14.45 Typical High $29.51 | Professional | 56 · Pre-op care only | $10.72 | $14.45 | $29.51 |
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 $134.90 Median $181.97 Typical High $213.80 | Professional | 32 · Mandated service | $134.90 | $181.97 | $213.80 |
Where Alabama sits
The same service costs 3.5 times more in North Carolina than in Indiana. 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· 21st of 51
$174
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.