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 $144.54 Median $891.25 Typical High $1,862.09 | Facility | None | $144.54 | $891.25 | $1,862.09 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $83.18 Typical High $144.54 | Professional | None | $58.88 | $83.18 | $144.54 |
Ambetter Setting Professional Modifier None Typical Low $60.26 Median $66.07 Typical High $70.79 | Professional | None | $60.26 | $66.07 | $70.79 |
BCBS Setting Facility Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Facility | None | $104.71 | $104.71 | $104.71 |
BCBS Setting Professional Modifier 32 · Mandated service Typical Low $53.70 Median $74.13 Typical High $109.65 | Professional | 32 · Mandated service | $53.70 | $74.13 | $109.65 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $58.88 Typical High $446.68 | Facility | None | $50.12 | $58.88 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $72.44 Typical High $117.49 | Professional | None | $47.86 | $72.44 | $117.49 |
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 $26.92 Median $58.88 Typical High $104.71 | Professional | None | $26.92 | $58.88 | $104.71 |
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 $29.51 Median $39.81 Typical High $70.79 | Professional | 52 · Reduced service | $29.51 | $39.81 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $15.85 Typical High $28.84 | Professional | 53 · Discontinued | $11.75 | $15.85 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $43.65 Median $60.26 Typical High $107.15 | Professional | 54 · Surgery only | $43.65 | $60.26 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $12.02 Typical High $21.38 | Professional | 55 · Aftercare only | $8.71 | $12.02 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $7.94 Typical High $14.45 | Professional | 56 · Pre-op care only | $5.89 | $7.94 | $14.45 |
Where Alabama sits
The same service costs 3.1 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· 26th of 51
$85.11
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.