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 $66.07 Median $616.60 Typical High $1,737.80 | Facility | None | $66.07 | $616.60 | $1,737.80 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $75.86 Typical High $114.82 | Professional | None | $66.07 | $75.86 | $114.82 |
Ambetter Setting Professional Modifier None Typical Low $24.55 Median $36.31 Typical High $48.98 | Professional | None | $24.55 | $36.31 | $48.98 |
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 $51.29 Median $64.57 Typical High $501.19 | Facility | None | $51.29 | $64.57 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $95.50 Typical High $125.89 | Professional | None | $66.07 | $95.50 | $125.89 |
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 $35.48 Median $63.10 Typical High $125.89 | Professional | None | $35.48 | $63.10 | $125.89 |
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 $32.36 Median $32.36 Typical High $56.23 | Professional | 52 · Reduced service | $32.36 | $32.36 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $13.18 Typical High $22.91 | Professional | 53 · Discontinued | $13.18 | $13.18 | $22.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $48.98 Median $48.98 Typical High $85.11 | Professional | 54 · Surgery only | $48.98 | $48.98 | $85.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $9.77 Typical High $16.98 | Professional | 55 · Aftercare only | $9.77 | $9.77 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $6.61 Typical High $11.48 | Professional | 56 · Pre-op care only | $6.61 | $6.61 | $11.48 |
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 $77.62 Median $107.15 Typical High $120.23 | Professional | 32 · Mandated service | $77.62 | $107.15 | $120.23 |
Where Alabama sits
The same service costs 3.5 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· 17th 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.