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 Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $346.74 | Professional | None | $239.88 | $239.88 | $346.74 |
Ambetter Setting Professional Modifier None Typical Low $158.49 Median $190.55 Typical High $223.87 | Professional | None | $158.49 | $190.55 | $223.87 |
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 $263.03 Median $269.15 Typical High $338.84 | Facility | None | $263.03 | $269.15 | $338.84 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | None | $263.03 | $263.03 | $263.03 |
United Setting Professional Modifier None Typical Low $213.80 Median $245.47 Typical High $281.84 | Professional | None | $213.80 | $245.47 | $281.84 |
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 $120.23 Median $120.23 Typical High $120.23 | Professional | 52 · Reduced service | $120.23 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | 53 · Discontinued | $47.86 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | 55 · Aftercare only | $36.31 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | 56 · Pre-op care only | $23.99 | $23.99 | $23.99 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 52 · Reduced service + 55 · Aftercare only Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 52 · Reduced service + 55 · Aftercare only | $234.42 | $234.42 | $234.42 |
Where Alabama sits
The same service costs 2.1 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.