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 $102.33 Median $208.93 Typical High $467.74 | Professional | None | $102.33 | $208.93 | $467.74 |
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 $100.00 Median $223.87 Typical High $371.54 | Professional | None | $100.00 | $223.87 | $371.54 |
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 $74.13 Median $234.42 Typical High $371.54 | Professional | None | $74.13 | $234.42 | $371.54 |
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 $66.07 Median $89.13 Typical High $234.42 | Professional | 52 · Reduced service | $66.07 | $89.13 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $35.48 Typical High $93.33 | Professional | 53 · Discontinued | $26.30 | $35.48 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $134.90 Typical High $346.74 | Professional | 54 · Surgery only | $100.00 | $134.90 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $26.92 Typical High $69.18 | Professional | 55 · Aftercare only | $19.95 | $26.92 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $17.78 Typical High $46.77 | Professional | 56 · Pre-op care only | $13.18 | $17.78 | $46.77 |
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 $218.78 Median $302.00 Typical High $354.81 | Professional | 32 · Mandated service | $218.78 | $302.00 | $354.81 |
Where Alabama sits
The same service costs 4.2 times more in Washington 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· 22nd of 51
$263
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.