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 $12.59 Median $27.54 Typical High $48.98 | Facility | None | $12.59 | $27.54 | $48.98 |
Aetna Setting Professional Modifier None Typical Low $27.54 Median $31.62 Typical High $48.98 | Professional | None | $27.54 | $31.62 | $48.98 |
Ambetter Setting Professional Modifier None Typical Low $16.98 Median $16.98 Typical High $16.98 | Professional | None | $16.98 | $16.98 | $16.98 |
BCBS Alabama Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Facility | None | $85.11 | $85.11 | $85.11 |
BCBS Alabama Setting Professional Modifier 32 · Mandated service Typical Low $31.62 Median $36.31 Typical High $48.98 | Professional | 32 · Mandated service | $31.62 | $36.31 | $48.98 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $102.33 Typical High $512.86 | Facility | None | $50.12 | $102.33 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $17.38 Median $28.18 Typical High $46.77 | Professional | None | $17.38 | $28.18 | $46.77 |
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 $13.80 Median $24.55 Typical High $39.81 | Professional | None | $13.80 | $24.55 | $39.81 |
5 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 $13.80 Median $13.80 Typical High $24.55 | Professional | 52 · Reduced service | $13.80 | $13.80 | $24.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.50 Median $5.50 Typical High $9.77 | Professional | 53 · Discontinued | $5.50 | $5.50 | $9.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $20.89 Median $20.89 Typical High $37.15 | Professional | 54 · Surgery only | $20.89 | $20.89 | $37.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.17 Median $4.17 Typical High $7.41 | Professional | 55 · Aftercare only | $4.17 | $4.17 | $7.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.75 Median $2.75 Typical High $4.90 | Professional | 56 · Pre-op care only | $2.75 | $2.75 | $4.90 |
Where Alabama sits
The same service costs 3.5 times more in Wisconsin 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· 29th of 51
$33.88
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.