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 $134.90 Median $776.25 Typical High $1,862.09 | Facility | None | $134.90 | $776.25 | $1,862.09 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $154.88 Typical High $257.04 | Professional | None | $134.90 | $154.88 | $257.04 |
Ambetter Setting Professional Modifier None Typical Low $72.44 Median $158.49 Typical High $158.49 | Professional | None | $72.44 | $158.49 | $158.49 |
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 $50.12 Median $104.71 Typical High $512.86 | Facility | None | $50.12 | $104.71 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $158.49 Typical High $213.80 | Professional | None | $102.33 | $158.49 | $213.80 |
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 $69.18 Median $128.82 Typical High $229.09 | Professional | None | $69.18 | $128.82 | $229.09 |
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 $67.61 Median $67.61 Typical High $128.82 | Professional | 52 · Reduced service | $67.61 | $67.61 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $27.54 Typical High $51.29 | Professional | 53 · Discontinued | $26.92 | $27.54 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $102.33 Typical High $194.98 | Professional | 54 · Surgery only | $102.33 | $102.33 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $20.42 Typical High $38.90 | Professional | 55 · Aftercare only | $20.42 | $20.42 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $13.80 Typical High $25.70 | Professional | 56 · Pre-op care only | $13.49 | $13.80 | $25.70 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $104.71 Median $104.71 Typical High $213.80 | Professional | 50 · Both sides | $104.71 | $104.71 | $213.80 |
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 32 · Mandated service Typical Low $123.03 Median $169.82 Typical High $177.83 | Professional | 32 · Mandated service | $123.03 | $169.82 | $177.83 |
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· 28th of 51
$158
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.