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 $645.65 Median $1,258.93 Typical High $3,388.44 | Facility | None | $645.65 | $1,258.93 | $3,388.44 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $1,584.89 Typical High $3,388.44 | Professional | None | $524.81 | $1,584.89 | $3,388.44 |
Ambetter Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $199.53 | Professional | None | $138.04 | $138.04 | $199.53 |
BCBS Alabama Setting Facility Modifier None Typical Low $6,025.60 Median $6,025.60 Typical High $6,025.60 | Facility | None | $6,025.60 | $6,025.60 | $6,025.60 |
BCBS Alabama Setting Professional Modifier None Typical Low $1,380.38 Median $1,905.46 Typical High $2,570.40 | Professional | None | $1,380.38 | $1,905.46 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $912.01 Typical High $2,398.83 | Professional | None | $346.74 | $912.01 | $2,398.83 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $5,128.61 Typical High $8,912.51 | Facility | None | $1,513.56 | $5,128.61 | $8,912.51 |
United Setting Professional Modifier None Typical Low $331.13 Median $1,621.81 Typical High $2,398.83 | Professional | None | $331.13 | $1,621.81 | $2,398.83 |
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 $323.59 Median $831.76 Typical High $1,698.24 | Professional | 52 · Reduced service | $323.59 | $831.76 | $1,698.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $331.13 Typical High $676.08 | Professional | 53 · Discontinued | $128.82 | $331.13 | $676.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $1,230.27 Typical High $2,570.40 | Professional | 54 · Surgery only | $489.78 | $1,230.27 | $2,570.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $251.19 Typical High $512.86 | Professional | 55 · Aftercare only | $97.72 | $251.19 | $512.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $165.96 Typical High $338.84 | Professional | 56 · Pre-op care only | $64.57 | $165.96 | $338.84 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $204.17 Median $204.17 Typical High $295.12 | Professional | 50 · Both sides | $204.17 | $204.17 | $295.12 |
BCBS Alabama Setting Facility Modifier 50 · Both sides Typical Low $8,912.51 Median $9,120.11 Typical High $9,120.11 | Facility | 50 · Both sides | $8,912.51 | $9,120.11 | $9,120.11 |
Where Alabama sits
The same service costs 6.2 times more in Washington than in Maryland. 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· 24th of 51
$1,862
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.