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 $489.78 Median $933.25 Typical High $1,862.09 | Facility | None | $489.78 | $933.25 | $1,862.09 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $173.78 Typical High $295.12 | Professional | None | $125.89 | $173.78 | $295.12 |
Ambetter Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $77.62 | Professional | None | $53.70 | $53.70 | $77.62 |
BCBS Alabama Setting Facility Modifier None Typical Low $2,630.27 Median $2,691.53 Typical High $2,691.53 | Facility | None | $2,630.27 | $2,691.53 | $2,691.53 |
BCBS Alabama Setting Professional Modifier None Typical Low $138.04 Median $190.55 Typical High $208.93 | Professional | None | $138.04 | $190.55 | $208.93 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $162.18 Typical High $295.12 | Professional | None | $81.28 | $162.18 | $295.12 |
United Setting Facility Modifier None Typical Low $251.19 Median $870.96 Typical High $1,737.80 | Facility | None | $251.19 | $870.96 | $1,737.80 |
United Setting Professional Modifier None Typical Low $64.57 Median $162.18 Typical High $269.15 | Professional | None | $64.57 | $162.18 | $269.15 |
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 $63.10 Median $81.28 Typical High $147.91 | Professional | 52 · Reduced service | $63.10 | $81.28 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $32.36 Typical High $60.26 | Professional | 53 · Discontinued | $25.12 | $32.36 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $123.03 Typical High $223.87 | Professional | 54 · Surgery only | $95.50 | $123.03 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $24.55 Typical High $44.67 | Professional | 55 · Aftercare only | $19.05 | $24.55 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $16.22 Typical High $29.51 | Professional | 56 · Pre-op care only | $12.59 | $16.22 | $29.51 |
Where Alabama sits
The same service costs 2.7 times more in Wisconsin than in Utah. 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· 19th of 51
$191
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.