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 Professional Modifier None Typical Low $87.10 Median $109.65 Typical High $158.49 | Professional | None | $87.10 | $109.65 | $158.49 |
Ambetter Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | None | $95.50 | $95.50 | $95.50 |
BCBS Alabama Setting Facility Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Facility | None | $275.42 | $275.42 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $75.86 Typical High $446.68 | Facility | None | $50.12 | $75.86 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $95.50 Typical High $123.03 | Professional | None | $79.43 | $95.50 | $123.03 |
United Setting Facility Modifier None Typical Low $100.00 Median $363.08 Typical High $1,380.38 | Facility | None | $100.00 | $363.08 | $1,380.38 |
United Setting Professional Modifier None Typical Low $54.95 Median $77.62 Typical High $131.83 | Professional | None | $54.95 | $77.62 | $131.83 |
6 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 $54.95 Median $54.95 Typical High $79.43 | Professional | 52 · Reduced service | $54.95 | $54.95 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $21.88 Typical High $31.62 | Professional | 53 · Discontinued | $21.88 | $21.88 | $31.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $16.22 Typical High $23.44 | Professional | 55 · Aftercare only | $16.22 | $16.22 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $10.96 Typical High $15.85 | Professional | 56 · Pre-op care only | $10.96 | $10.96 | $15.85 |
BCBS Alabama Setting Facility Modifier 50 · Both sides Typical Low $407.38 Median $416.87 Typical High $416.87 | Facility | 50 · Both sides | $407.38 | $416.87 | $416.87 |
BCBS Alabama Setting Professional Modifier 32 · Mandated service Typical Low $72.44 Median $100.00 Typical High $125.89 | Professional | 32 · Mandated service | $72.44 | $100.00 | $125.89 |
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· 21st of 51
$110
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.