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 $69.18 Median $691.83 Typical High $1,862.09 | Facility | None | $69.18 | $691.83 | $1,862.09 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $85.11 Typical High $144.54 | Professional | None | $69.18 | $85.11 | $144.54 |
Ambetter Setting Professional Modifier None Typical Low $74.13 Median $81.28 Typical High $123.03 | Professional | None | $74.13 | $81.28 | $123.03 |
BCBS Alabama Setting Facility Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Facility | None | $288.40 | $288.40 | $288.40 |
BCBS Alabama Setting Professional Modifier 32 · Mandated service Typical Low $87.10 Median $114.82 Typical High $128.82 | Professional | 32 · Mandated service | $87.10 | $114.82 | $128.82 |
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 $57.54 Median $75.86 Typical High $120.23 | Professional | None | $57.54 | $75.86 | $120.23 |
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 $44.67 Median $72.44 Typical High $102.33 | Professional | None | $44.67 | $72.44 | $102.33 |
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 $34.67 Median $44.67 Typical High $72.44 | Professional | 52 · Reduced service | $34.67 | $44.67 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $17.78 Typical High $28.84 | Professional | 53 · Discontinued | $13.80 | $17.78 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $52.48 Median $67.61 Typical High $107.15 | Professional | 54 · Surgery only | $52.48 | $67.61 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $13.49 Typical High $21.38 | Professional | 55 · Aftercare only | $10.47 | $13.49 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $8.91 Typical High $14.45 | Professional | 56 · Pre-op care only | $6.92 | $8.91 | $14.45 |
Where Alabama sits
The same service costs 3.2 times more in Alaska than in New York. 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· 45th of 51
$91.20
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.