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 $48.98 Median $691.83 Typical High $1,862.09 | Facility | None | $48.98 | $691.83 | $1,862.09 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $56.23 Typical High $85.11 | Professional | None | $45.71 | $56.23 | $85.11 |
Ambetter Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | None | $42.66 | $42.66 | $42.66 |
BCBS Alabama Setting Facility Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Facility | None | $104.71 | $104.71 | $104.71 |
BCBS Alabama Setting Professional Modifier None Typical Low $32.36 Median $44.67 Typical High $61.66 | Professional | None | $32.36 | $44.67 | $61.66 |
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 $29.51 Median $46.77 Typical High $77.62 | Professional | None | $29.51 | $46.77 | $77.62 |
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 $21.88 Median $37.15 Typical High $72.44 | Professional | None | $21.88 | $37.15 | $72.44 |
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 $24.55 Median $24.55 Typical High $41.69 | Professional | 52 · Reduced service | $24.55 | $24.55 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $9.77 Typical High $16.98 | Professional | 53 · Discontinued | $9.77 | $9.77 | $16.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $37.15 Median $37.15 Typical High $63.10 | Professional | 54 · Surgery only | $37.15 | $37.15 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $7.41 Typical High $12.59 | Professional | 55 · Aftercare only | $7.41 | $7.41 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $4.90 Typical High $8.51 | Professional | 56 · Pre-op care only | $4.90 | $4.90 | $8.51 |
Where Alabama sits
The same service costs 3.4 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· 34th of 51
$50.12
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.