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 $125.89 Median $134.90 Typical High $204.17 | Professional | None | $125.89 | $134.90 | $204.17 |
Ambetter Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $181.97 | Professional | None | $134.90 | $134.90 | $181.97 |
BCBS Alabama Setting Facility Modifier None Typical Low $660.69 Median $676.08 Typical High $676.08 | Facility | None | $660.69 | $676.08 | $676.08 |
BCBS Alabama Setting Professional Modifier 32 · Mandated service Typical Low $117.49 Median $162.18 Typical High $218.78 | Professional | 32 · Mandated service | $117.49 | $162.18 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $93.33 Typical High $501.19 | Facility | None | $75.86 | $93.33 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $144.54 Typical High $186.21 | Professional | None | $112.20 | $144.54 | $186.21 |
United Setting Facility Modifier None Typical Low $100.00 Median $371.54 Typical High $1,380.38 | Facility | None | $100.00 | $371.54 | $1,380.38 |
United Setting Professional Modifier None Typical Low $87.10 Median $131.83 Typical High $177.83 | Professional | None | $87.10 | $131.83 | $177.83 |
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 $67.61 Median $67.61 Typical High $100.00 | Professional | 52 · Reduced service | $67.61 | $67.61 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $27.54 Typical High $40.74 | Professional | 53 · Discontinued | $27.54 | $27.54 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $102.33 Typical High $151.36 | Professional | 54 · Surgery only | $102.33 | $102.33 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $20.42 Typical High $30.20 | Professional | 55 · Aftercare only | $20.42 | $20.42 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $13.49 Typical High $20.42 | Professional | 56 · Pre-op care only | $13.49 | $13.49 | $20.42 |
Where Alabama sits
The same service costs 3.2 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· 40th of 51
$148
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.