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 $81.28 Median $109.65 Typical High $138.04 | Facility | None | $81.28 | $109.65 | $138.04 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $109.65 Typical High $134.90 | Professional | None | $81.28 | $109.65 | $134.90 |
Ambetter Setting Professional Modifier None Typical Low $93.33 Median $144.54 Typical High $181.97 | Professional | None | $93.33 | $144.54 | $181.97 |
BCBS Alabama Setting Professional Modifier None Typical Low $87.10 Median $204.17 Typical High $316.23 | Professional | None | $87.10 | $204.17 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $114.82 Median $134.90 Typical High $151.36 | Facility | None | $114.82 | $134.90 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $112.20 Typical High $154.88 | Professional | None | $104.71 | $112.20 | $154.88 |
United Setting Professional Modifier None Typical Low $100.00 Median $125.89 Typical High $165.96 | Professional | None | $100.00 | $125.89 | $165.96 |
10 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 $54.95 Median $63.10 Typical High $67.61 | Professional | 52 · Reduced service | $54.95 | $63.10 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $19.05 Typical High $20.42 | Professional | 55 · Aftercare only | $16.22 | $19.05 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $12.59 Typical High $13.49 | Professional | 56 · Pre-op care only | $10.96 | $12.59 | $13.49 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $93.33 Median $162.18 Typical High $204.17 | Professional | 25 · Same-day visit | $93.33 | $162.18 | $204.17 |
Ambetter Setting Professional Modifier 57 · Decision for surgery Typical Low $147.91 Median $169.82 Typical High $218.78 | Professional | 57 · Decision for surgery | $147.91 | $169.82 | $218.78 |
Ambetter Setting Professional Modifier 93 · Audio-only telehealth Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | 93 · Audio-only telehealth | $109.65 | $109.65 | $109.65 |
Ambetter Setting Professional Modifier FQ · Audio-only Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | FQ · Audio-only | $109.65 | $109.65 | $109.65 |
Ambetter Setting Professional Modifier FS · Shared visit Typical Low $117.49 Median $147.91 Typical High $223.87 | Professional | FS · Shared visit | $117.49 | $147.91 | $223.87 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | GC · Resident with teaching physician | $109.65 | $109.65 | $109.65 |
BCBS Alabama Setting Professional Modifier 10 Typical Low $97.72 Median $134.90 Typical High $194.98 | Professional | 10 | $97.72 | $134.90 | $194.98 |
Where Alabama sits
The same service costs 2.3 times more in Alaska 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
$115
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.