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 $602.56 Median $1,096.48 Typical High $1,905.46 | Facility | None | $602.56 | $1,096.48 | $1,905.46 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $537.03 Typical High $977.24 | Professional | None | $204.17 | $537.03 | $977.24 |
Ambetter Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | None | $169.82 | $169.82 | $169.82 |
BCBS Alabama Setting Facility Modifier None Typical Low $912.01 Median $933.25 Typical High $933.25 | Facility | None | $912.01 | $933.25 | $933.25 |
BCBS Alabama Setting Professional Modifier None Typical Low $426.58 Median $588.84 Typical High $660.69 | Professional | None | $426.58 | $588.84 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $467.74 Typical High $1,000.00 | Professional | None | $208.93 | $467.74 | $1,000.00 |
United Setting Facility Modifier None Typical Low $251.19 Median $851.14 Typical High $1,698.24 | Facility | None | $251.19 | $851.14 | $1,698.24 |
United Setting Professional Modifier None Typical Low $131.83 Median $489.78 Typical High $776.25 | Professional | None | $131.83 | $489.78 | $776.25 |
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 $123.03 Median $269.15 Typical High $489.78 | Professional | 52 · Reduced service | $123.03 | $269.15 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $107.15 Typical High $194.98 | Professional | 53 · Discontinued | $48.98 | $107.15 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $398.11 Typical High $741.31 | Professional | 54 · Surgery only | $186.21 | $398.11 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $79.43 Typical High $147.91 | Professional | 55 · Aftercare only | $37.15 | $79.43 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $53.70 Typical High $97.72 | Professional | 56 · Pre-op care only | $24.55 | $53.70 | $97.72 |
BCBS Alabama Setting Facility Modifier 50 · Both sides Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Facility | 50 · Both sides | $1,380.38 | $1,380.38 | $1,380.38 |
Where Alabama sits
The same service costs 3.8 times more in Wisconsin than in Nebraska. 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
$589
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.