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 $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $89.13 Typical High $89.13 | Professional | None | $75.86 | $89.13 | $89.13 |
Ambetter Setting Professional Modifier None Typical Low $50.12 Median $54.95 Typical High $54.95 | Professional | None | $50.12 | $54.95 | $54.95 |
BCBS Alabama Setting Facility Modifier None Typical Low $602.56 Median $602.56 Typical High $602.56 | Facility | None | $602.56 | $602.56 | $602.56 |
BCBS Alabama Setting Professional Modifier 12 Typical Low $81.28 Median $100.00 Typical High $134.90 | Professional | 12 | $81.28 | $100.00 | $134.90 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $70.79 Typical High $87.10 | Professional | None | $61.66 | $70.79 | $87.10 |
United Setting Facility Modifier None Typical Low $794.33 Median $831.76 Typical High $1,096.48 | Facility | None | $794.33 | $831.76 | $1,096.48 |
United Setting Professional Modifier None Typical Low $52.48 Median $72.44 Typical High $95.50 | Professional | None | $52.48 | $72.44 | $95.50 |
4 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 $44.67 Median $44.67 Typical High $44.67 | Professional | 52 · Reduced service | $44.67 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $17.78 Typical High $17.78 | Professional | 53 · Discontinued | $17.78 | $17.78 | $17.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $13.18 Typical High $13.18 | Professional | 55 · Aftercare only | $13.18 | $13.18 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $8.91 Typical High $8.91 | Professional | 56 · Pre-op care only | $8.91 | $8.91 | $8.91 |
Where Alabama sits
The same service costs 3.2 times more in Alaska 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· 41st of 51
$72.44
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.