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 $102.33 Median $831.76 Typical High $1,862.09 | Facility | None | $102.33 | $831.76 | $1,862.09 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $117.49 Typical High $186.21 | Professional | None | $100.00 | $117.49 | $186.21 |
Ambetter Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $95.50 | Professional | None | $87.10 | $87.10 | $95.50 |
BCBS Alabama Setting Facility Modifier None Typical Low $288.40 Median $295.12 Typical High $295.12 | Facility | None | $288.40 | $295.12 | $295.12 |
BCBS Alabama Setting Professional Modifier 32 · Mandated service Typical Low $67.61 Median $93.33 Typical High $138.04 | Professional | 32 · Mandated service | $67.61 | $93.33 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $64.57 Median $81.28 Typical High $501.19 | Facility | None | $64.57 | $81.28 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $91.20 Typical High $131.83 | Professional | None | $54.95 | $91.20 | $131.83 |
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 $44.67 Median $77.62 Typical High $128.82 | Professional | None | $44.67 | $77.62 | $128.82 |
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 $51.29 Median $51.29 Typical High $93.33 | Professional | 52 · Reduced service | $51.29 | $51.29 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $20.42 Typical High $37.15 | Professional | 53 · Discontinued | $20.42 | $20.42 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $75.86 Typical High $138.04 | Professional | 54 · Surgery only | $75.86 | $75.86 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $15.14 Typical High $27.54 | Professional | 55 · Aftercare only | $15.14 | $15.14 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $10.23 Typical High $18.62 | Professional | 56 · Pre-op care only | $10.23 | $10.23 | $18.62 |
Where Alabama sits
The same service costs 2.8 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· 33rd of 51
$102
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.