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 $338.84 Median $338.84 Typical High $338.84 | Facility | None | $338.84 | $338.84 | $338.84 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $489.78 | Professional | None | $338.84 | $338.84 | $489.78 |
Ambetter Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $316.23 | Professional | None | $269.15 | $269.15 | $316.23 |
BCBS Alabama Setting Facility Modifier None Typical Low $158.49 Median $162.18 Typical High $162.18 | Facility | None | $158.49 | $162.18 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $380.19 Typical High $478.63 | Facility | None | $371.54 | $380.19 | $478.63 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $371.54 Typical High $371.54 | Professional | None | $316.23 | $371.54 | $371.54 |
United Setting Professional Modifier None Typical Low $331.13 Median $371.54 Typical High $398.11 | Professional | None | $331.13 | $371.54 | $398.11 |
5 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 $165.96 Median $165.96 Typical High $165.96 | Professional | 52 · Reduced service | $165.96 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | 53 · Discontinued | $67.61 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | 55 · Aftercare only | $50.12 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | 56 · Pre-op care only | $33.88 | $33.88 | $33.88 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 52 · Reduced service Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 52 · Reduced service | $331.13 | $331.13 | $331.13 |
Where Alabama sits
The same service costs 3.0 times more in Arizona than in Alabama. 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· 51st of 51
$162
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.