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 $21.38 Median $33.88 Typical High $45.71 | Facility | None | $21.38 | $33.88 | $45.71 |
Aetna Setting Professional Modifier None Typical Low $21.38 Median $33.88 Typical High $45.71 | Professional | None | $21.38 | $33.88 | $45.71 |
Ambetter Setting Professional Modifier None Typical Low $25.12 Median $45.71 Typical High $56.23 | Professional | None | $25.12 | $45.71 | $56.23 |
BCBS Alabama Setting Professional Modifier None Typical Low $33.11 Median $75.86 Typical High $120.23 | Professional | None | $33.11 | $75.86 | $120.23 |
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 $21.38 Median $35.48 Typical High $40.74 | Professional | None | $21.38 | $35.48 | $40.74 |
United Setting Professional Modifier None Typical Low $19.95 Median $31.62 Typical High $48.98 | Professional | None | $19.95 | $31.62 | $48.98 |
7 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 $14.45 Median $17.78 Typical High $22.39 | Professional | 52 · Reduced service | $14.45 | $17.78 | $22.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $5.37 Typical High $6.76 | Professional | 55 · Aftercare only | $4.37 | $5.37 | $6.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.88 Median $3.55 Typical High $4.57 | Professional | 56 · Pre-op care only | $2.88 | $3.55 | $4.57 |
Ambetter Setting Professional Modifier 24 · Unrelated visit after surgery Typical Low $35.48 Median $53.70 Typical High $70.79 | Professional | 24 · Unrelated visit after surgery | $35.48 | $53.70 | $70.79 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $43.65 Median $48.98 Typical High $57.54 | Professional | 25 · Same-day visit | $43.65 | $48.98 | $57.54 |
Ambetter Setting Professional Modifier 93 · Audio-only telehealth Typical Low $25.12 Median $25.12 Typical High $33.88 | Professional | 93 · Audio-only telehealth | $25.12 | $25.12 | $33.88 |
BCBS Alabama Setting Professional Modifier 10 Typical Low $32.36 Median $44.67 Typical High $64.57 | Professional | 10 | $32.36 | $44.67 | $64.57 |
Where Alabama sits
The same service costs 2.4 times more in Alaska than in New Jersey. 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· 50th of 51
$33.88
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.