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 $776.25 Median $1,258.93 Typical High $2,630.27 | Facility | None | $776.25 | $1,258.93 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $45.71 Typical High $64.57 | Professional | None | $41.69 | $45.71 | $64.57 |
Ambetter Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | None | $45.71 | $45.71 | $45.71 |
BCBS Alabama Setting Facility Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Facility | None | $162.18 | $162.18 | $162.18 |
BCBS Alabama Setting Professional Modifier None Typical Low $35.48 Median $48.98 Typical High $74.13 | Professional | None | $35.48 | $48.98 | $74.13 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $549.54 Typical High $2,630.27 | Facility | None | $446.68 | $549.54 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | None | $46.77 | $46.77 | $46.77 |
United Setting Facility Modifier None Typical Low $100.00 Median $371.54 Typical High $1,380.38 | Facility | None | $100.00 | $371.54 | $1,380.38 |
United Setting Professional Modifier None Typical Low $27.54 Median $42.66 Typical High $67.61 | Professional | None | $27.54 | $42.66 | $67.61 |
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 $20.89 Median $20.89 Typical High $32.36 | Professional | 52 · Reduced service | $20.89 | $20.89 | $32.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $8.32 Typical High $12.88 | Professional | 53 · Discontinued | $8.32 | $8.32 | $12.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $30.90 Median $30.90 Typical High $47.86 | Professional | 54 · Surgery only | $30.90 | $30.90 | $47.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $6.17 Typical High $9.55 | Professional | 55 · Aftercare only | $6.17 | $6.17 | $9.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $4.17 Typical High $6.46 | Professional | 56 · Pre-op care only | $4.17 | $4.17 | $6.46 |
Where Alabama sits
The same service costs 2.8 times more in Alaska than in California. 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· 40th of 51
$48.98
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.