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 $489.78 Median $933.25 Typical High $1,862.09 | Facility | None | $489.78 | $933.25 | $1,862.09 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $107.15 Typical High $165.96 | Professional | None | $85.11 | $107.15 | $165.96 |
Ambetter Setting Professional Modifier None Typical Low $46.77 Median $109.65 Typical High $112.20 | Professional | None | $46.77 | $109.65 | $112.20 |
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 $81.28 Median $100.00 Typical High $501.19 | Facility | None | $81.28 | $100.00 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $154.88 Typical High $213.80 | Professional | None | $120.23 | $154.88 | $213.80 |
United Setting Facility Modifier None Typical Low $316.23 Median $645.65 Typical High $2,511.89 | Facility | None | $316.23 | $645.65 | $2,511.89 |
United Setting Professional Modifier None Typical Low $45.71 Median $91.20 Typical High $194.98 | Professional | None | $45.71 | $91.20 | $194.98 |
7 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 $47.86 Typical High $83.18 | Professional | 52 · Reduced service | $42.66 | $47.86 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $19.50 Typical High $33.11 | Professional | 53 · Discontinued | $17.38 | $19.50 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $72.44 Typical High $125.89 | Professional | 54 · Surgery only | $64.57 | $72.44 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $14.45 Typical High $25.12 | Professional | 55 · Aftercare only | $12.88 | $14.45 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $9.77 Typical High $16.60 | Professional | 56 · Pre-op care only | $8.51 | $9.77 | $16.60 |
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 $95.50 Median $131.83 Typical High $169.82 | Professional | 32 · Mandated service | $95.50 | $131.83 | $169.82 |
Where Alabama sits
The same service costs 3.2 times more in Alaska than in Virginia. 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· 11th of 51
$155
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.