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 $776.25 Median $1,258.93 Typical High $2,630.27 | Facility | None | $776.25 | $1,258.93 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $24.55 Median $37.15 Typical High $42.66 | Professional | None | $24.55 | $37.15 | $42.66 |
Ambetter Setting Professional Modifier None Typical Low $14.79 Median $15.49 Typical High $21.88 | Professional | None | $14.79 | $15.49 | $21.88 |
BCBS Alabama Setting Facility Modifier None Typical Low $104.71 Median $107.15 Typical High $107.15 | Facility | None | $104.71 | $107.15 | $107.15 |
BCBS Alabama Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | None | $42.66 | $42.66 | $42.66 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $102.33 Typical High $512.86 | Facility | None | $50.12 | $102.33 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $54.95 Typical High $85.11 | Professional | None | $47.86 | $54.95 | $85.11 |
United Setting Facility Modifier None Typical Low $100.00 Median $363.08 Typical High $1,380.38 | Facility | None | $100.00 | $363.08 | $1,380.38 |
United Setting Professional Modifier None Typical Low $21.88 Median $27.54 Typical High $58.88 | Professional | None | $21.88 | $27.54 | $58.88 |
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 $15.49 Median $18.62 Typical High $21.38 | Professional | 52 · Reduced service | $15.49 | $18.62 | $21.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.17 Median $7.41 Typical High $8.51 | Professional | 53 · Discontinued | $6.17 | $7.41 | $8.51 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $22.91 Median $27.54 Typical High $32.36 | Professional | 54 · Surgery only | $22.91 | $27.54 | $32.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.57 Median $5.50 Typical High $6.46 | Professional | 55 · Aftercare only | $4.57 | $5.50 | $6.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $3.72 Typical High $4.27 | Professional | 56 · Pre-op care only | $3.09 | $3.72 | $4.27 |
BCBS Alabama Setting Facility Modifier 50 · Both sides Typical Low $158.49 Median $158.49 Typical High $158.49 | Facility | 50 · Both sides | $158.49 | $158.49 | $158.49 |
BCBS Alabama Setting Professional Modifier 32 · Mandated service Typical Low $26.92 Median $33.11 Typical High $42.66 | Professional | 32 · Mandated service | $26.92 | $33.11 | $42.66 |
Where Alabama sits
The same service costs 4.3 times more in Wyoming than in New York. 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· 12th of 51
$51.29
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.