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 $562.34 Median $954.99 Typical High $2,398.83 | Facility | None | $562.34 | $954.99 | $2,398.83 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $257.04 | Professional | None | $154.88 | $154.88 | $257.04 |
Ambetter Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | None | $70.79 | $70.79 | $70.79 |
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 $95.50 Median $128.82 Typical High $194.98 | Professional | 32 · Mandated service | $95.50 | $128.82 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $295.12 Median $363.08 Typical High $501.19 | Facility | None | $295.12 | $363.08 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $131.83 Typical High $204.17 | Professional | None | $85.11 | $131.83 | $204.17 |
United Setting Facility Modifier None Typical Low $309.03 Median $616.60 Typical High $2,511.89 | Facility | None | $309.03 | $616.60 | $2,511.89 |
United Setting Professional Modifier None Typical Low $67.61 Median $109.65 Typical High $181.97 | Professional | None | $67.61 | $109.65 | $181.97 |
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 $77.62 Median $77.62 Typical High $128.82 | Professional | 52 · Reduced service | $77.62 | $77.62 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $30.90 Typical High $51.29 | Professional | 53 · Discontinued | $30.90 | $30.90 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $117.49 Typical High $194.98 | Professional | 54 · Surgery only | $117.49 | $117.49 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $23.44 Typical High $38.90 | Professional | 55 · Aftercare only | $23.44 | $23.44 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $15.49 Typical High $25.70 | Professional | 56 · Pre-op care only | $15.49 | $15.49 | $25.70 |
Where Alabama sits
The same service costs 3.6 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· 30th of 51
$162
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.