How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $50.12 Median $64.57 Typical High $93.33 | Facility | None | $50.12 | $64.57 | $93.33 |
Aetna Setting Professional Modifier None Typical Low $50.12 Median $57.54 Typical High $100.00 | Professional | None | $50.12 | $57.54 | $100.00 |
Ambetter Setting Professional Modifier None Typical Low $58.88 Median $74.13 Typical High $95.50 | Professional | None | $58.88 | $74.13 | $95.50 |
BCBS Alabama Setting Professional Modifier None Typical Low $70.79 Median $93.33 Typical High $107.15 | Professional | None | $70.79 | $93.33 | $107.15 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $85.11 Typical High $134.90 | Professional | None | $74.13 | $85.11 | $134.90 |
United Setting Professional Modifier None Typical Low $58.88 Median $97.72 Typical High $131.83 | Professional | None | $58.88 | $97.72 | $131.83 |
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 $33.88 Median $33.88 Typical High $38.02 | Professional | 52 · Reduced service | $33.88 | $33.88 | $38.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.00 Typical High $11.48 | Professional | 55 · Aftercare only | $10.00 | $10.00 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $6.76 Typical High $7.59 | Professional | 56 · Pre-op care only | $6.76 | $6.76 | $7.59 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $70.79 Median $70.79 Typical High $95.50 | Professional | 25 · Same-day visit | $70.79 | $70.79 | $95.50 |
Ambetter Setting Professional Modifier 57 · Decision for surgery Typical Low $70.79 Median $74.13 Typical High $79.43 | Professional | 57 · Decision for surgery | $70.79 | $74.13 | $79.43 |
Ambetter Setting Professional Modifier FS · Shared visit Typical Low $74.13 Median $91.20 Typical High $95.50 | Professional | FS · Shared visit | $74.13 | $91.20 | $95.50 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | GC · Resident with teaching physician | $70.79 | $70.79 | $70.79 |
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
$74.13
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.