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 $1,230.27 Typical High $2,398.83 | Facility | None | $645.65 | $1,230.27 | $2,398.83 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $1,096.48 Typical High $2,041.74 | Professional | None | $380.19 | $1,096.48 | $2,041.74 |
Ambetter Setting Professional Modifier None Typical Low $131.83 Median $199.53 Typical High $199.53 | Professional | None | $131.83 | $199.53 | $199.53 |
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 $912.01 Median $1,258.93 Typical High $1,412.54 | Professional | None | $912.01 | $1,258.93 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $602.56 Typical High $1,737.80 | Professional | None | $269.15 | $602.56 | $1,737.80 |
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 $213.80 Median $1,071.52 Typical High $1,698.24 | Professional | None | $213.80 | $1,071.52 | $1,698.24 |
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 $208.93 Median $549.54 Typical High $1,023.29 | Professional | 52 · Reduced service | $208.93 | $549.54 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $218.78 Typical High $407.38 | Professional | 53 · Discontinued | $85.11 | $218.78 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $812.83 Typical High $1,548.82 | Professional | 54 · Surgery only | $316.23 | $812.83 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $165.96 Typical High $309.03 | Professional | 55 · Aftercare only | $63.10 | $165.96 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $109.65 Typical High $204.17 | Professional | 56 · Pre-op care only | $41.69 | $109.65 | $204.17 |
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 5.8 times more in Washington than in Hawaii. 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· 30th of 51
$1,000
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.