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 $169.82 Median $169.82 Typical High $169.82 | Facility | None | $169.82 | $169.82 | $169.82 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | None | $169.82 | $169.82 | $169.82 |
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 $218.78 Median $223.87 Typical High $288.40 | Facility | None | $218.78 | $223.87 | $288.40 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $275.42 | Professional | None | $218.78 | $218.78 | $275.42 |
United Setting Facility Modifier None Typical Low $199.53 Median $213.80 Typical High $213.80 | Facility | None | $199.53 | $213.80 | $213.80 |
United Setting Professional Modifier None Typical Low $165.96 Median $186.21 Typical High $234.42 | Professional | None | $165.96 | $186.21 | $234.42 |
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 $85.11 Median $85.11 Typical High $85.11 | Professional | 52 · Reduced service | $85.11 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | 53 · Discontinued | $33.88 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | 55 · Aftercare only | $25.70 | $25.70 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $16.98 Typical High $16.98 | Professional | 56 · Pre-op care only | $16.98 | $16.98 | $16.98 |
BCBS Alabama Setting Professional Modifier 12 + 32 · Mandated service Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | 12 + 32 · Mandated service | $194.98 | $194.98 | $194.98 |
Where Alabama sits
The same service costs 1.8 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.