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 $85.11 Median $891.25 Typical High $1,862.09 | Facility | None | $85.11 | $891.25 | $1,862.09 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $87.10 Typical High $169.82 | Professional | None | $85.11 | $87.10 | $169.82 |
Ambetter Setting Professional Modifier None Typical Low $18.62 Median $79.43 Typical High $79.43 | Professional | None | $18.62 | $79.43 | $79.43 |
BCBS Alabama Setting Facility Modifier None Typical Low $549.54 Median $562.34 Typical High $562.34 | Facility | None | $549.54 | $562.34 | $562.34 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $85.11 Typical High $112.20 | Professional | None | $64.57 | $85.11 | $112.20 |
United Setting Facility Modifier None Typical Low $251.19 Median $870.96 Typical High $1,698.24 | Facility | None | $251.19 | $870.96 | $1,698.24 |
United Setting Professional Modifier None Typical Low $36.31 Median $72.44 Typical High $144.54 | Professional | None | $36.31 | $72.44 | $144.54 |
6 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 $42.66 Median $42.66 Typical High $85.11 | Professional | 52 · Reduced service | $42.66 | $42.66 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $16.98 Typical High $33.88 | Professional | 53 · Discontinued | $16.98 | $16.98 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $64.57 Typical High $125.89 | Professional | 54 · Surgery only | $64.57 | $64.57 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $12.88 Typical High $25.12 | Professional | 55 · Aftercare only | $12.88 | $12.88 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $8.51 Typical High $16.98 | Professional | 56 · Pre-op care only | $8.51 | $8.51 | $16.98 |
BCBS Alabama Setting Professional Modifier 32 · Mandated service Typical Low $61.66 Median $85.11 Typical High $141.25 | Professional | 32 · Mandated service | $61.66 | $85.11 | $141.25 |
Where Alabama sits
The same service costs 2.5 times more in North Carolina than in Florida. 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· 43rd 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.