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 $81.28 Median $776.25 Typical High $1,862.09 | Facility | None | $81.28 | $776.25 | $1,862.09 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $93.33 Typical High $114.82 | Professional | None | $81.28 | $93.33 | $114.82 |
BCBS Alabama Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $38.90 Median $48.98 Typical High $501.19 | Facility | None | $38.90 | $48.98 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $109.65 Typical High $154.88 | Professional | None | $85.11 | $109.65 | $154.88 |
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 $63.10 Typical High $141.25 | Professional | None | $44.67 | $63.10 | $141.25 |
8 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 $40.74 Median $40.74 Typical High $57.54 | Professional | 52 · Reduced service | $40.74 | $40.74 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $16.22 Typical High $22.91 | Professional | 53 · Discontinued | $16.22 | $16.22 | $22.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $61.66 Typical High $87.10 | Professional | 54 · Surgery only | $61.66 | $61.66 | $87.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $12.30 Typical High $17.38 | Professional | 55 · Aftercare only | $12.30 | $12.30 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $8.13 Typical High $11.48 | Professional | 56 · Pre-op care only | $8.13 | $8.13 | $11.48 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | 50 · Both sides | $117.49 | $117.49 | $117.49 |
BCBS Alabama Setting Facility Modifier 50 · Both sides Typical Low $954.99 Median $954.99 Typical High $954.99 | Facility | 50 · Both sides | $954.99 | $954.99 | $954.99 |
BCBS Alabama Setting Professional Modifier 32 · Mandated service Typical Low $69.18 Median $95.50 Typical High $104.71 | Professional | 32 · Mandated service | $69.18 | $95.50 | $104.71 |
Where Alabama sits
The same service costs 3.2 times more in Alaska than in Texas. 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· 17th of 51
$100
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.