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 $562.34 Median $954.99 Typical High $2,398.83 | Facility | None | $562.34 | $954.99 | $2,398.83 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $91.20 Typical High $100.00 | Professional | None | $58.88 | $91.20 | $100.00 |
Ambetter Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $64.57 | Professional | None | $47.86 | $47.86 | $64.57 |
BCBS Alabama Setting Facility Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Facility | None | $457.09 | $457.09 | $457.09 |
BCBS Alabama Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | None | $93.33 | $93.33 | $93.33 |
Cigna Setting Facility Modifier None Typical Low $23.99 Median $30.20 Typical High $501.19 | Facility | None | $23.99 | $30.20 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $100.00 Typical High $154.88 | Professional | None | $85.11 | $100.00 | $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 $46.77 Median $60.26 Typical High $95.50 | Professional | None | $46.77 | $60.26 | $95.50 |
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 $35.48 Median $45.71 Typical High $48.98 | Professional | 52 · Reduced service | $35.48 | $45.71 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $18.20 Typical High $19.95 | Professional | 53 · Discontinued | $14.13 | $18.20 | $19.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $52.48 Median $67.61 Typical High $74.13 | Professional | 54 · Surgery only | $52.48 | $67.61 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $13.80 Typical High $14.79 | Professional | 55 · Aftercare only | $10.47 | $13.80 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $9.12 Typical High $10.00 | Professional | 56 · Pre-op care only | $7.08 | $9.12 | $10.00 |
BCBS Alabama Setting Facility Modifier 50 · Both sides Typical Low $691.83 Median $691.83 Typical High $691.83 | Facility | 50 · Both sides | $691.83 | $691.83 | $691.83 |
BCBS Alabama Setting Professional Modifier 32 · Mandated service Typical Low $67.61 Median $87.10 Typical High $93.33 | Professional | 32 · Mandated service | $67.61 | $87.10 | $93.33 |
Where Alabama sits
The same service costs 3.6 times more in Wyoming than in Florida. 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· 10th 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.