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 Professional Modifier None Typical Low $467.74 Median $616.60 Typical High $794.33 | Professional | None | $467.74 | $616.60 | $794.33 |
Ambetter Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | None | $512.86 | $512.86 | $512.86 |
BCBS Alabama Setting Facility Modifier None Typical Low $354.81 Median $363.08 Typical High $363.08 | Facility | None | $354.81 | $363.08 | $363.08 |
BCBS Alabama Setting Professional Modifier 12 Typical Low $398.11 Median $537.03 Typical High $812.83 | Professional | 12 | $398.11 | $537.03 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $512.86 Typical High $2,630.27 | Facility | None | $446.68 | $512.86 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $467.74 Typical High $588.84 | Professional | None | $371.54 | $467.74 | $588.84 |
United Setting Facility Modifier None Typical Low $371.54 Median $954.99 Typical High $3,801.89 | Facility | None | $371.54 | $954.99 | $3,801.89 |
United Setting Professional Modifier None Typical Low $309.03 Median $416.87 Typical High $660.69 | Professional | None | $309.03 | $416.87 | $660.69 |
3 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 $302.00 Median $302.00 Typical High $398.11 | Professional | 52 · Reduced service | $302.00 | $302.00 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $91.20 Typical High $117.49 | Professional | 55 · Aftercare only | $91.20 | $91.20 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $61.66 Typical High $79.43 | Professional | 56 · Pre-op care only | $61.66 | $61.66 | $79.43 |
Where Alabama sits
The same service costs 3.1 times more in Alaska than in Indiana. 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· 47th of 51
$468
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.