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 Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | None | $263.03 | $263.03 | $263.03 |
Ambetter Setting Professional Modifier None Typical Low $89.13 Median $114.82 Typical High $239.88 | Professional | None | $89.13 | $114.82 | $239.88 |
BCBS Alabama Setting Facility Modifier None Typical Low $741.31 Median $758.58 Typical High $758.58 | Facility | None | $741.31 | $758.58 | $758.58 |
BCBS Alabama Setting Professional Modifier 22 · Increased work Typical Low $169.82 Median $234.42 Typical High $309.03 | Professional | 22 · Increased work | $169.82 | $234.42 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $501.19 | Facility | None | $263.03 | $263.03 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
United Setting Facility Modifier None Typical Low $380.19 Median $398.11 Typical High $524.81 | Facility | None | $380.19 | $398.11 | $524.81 |
United Setting Professional Modifier None Typical Low $131.83 Median $218.78 Typical High $316.23 | Professional | None | $131.83 | $218.78 | $316.23 |
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 $131.83 Median $131.83 Typical High $131.83 | Professional | 52 · Reduced service | $131.83 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | 53 · Discontinued | $52.48 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | 55 · Aftercare only | $39.81 | $39.81 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $26.30 Typical High $26.30 | Professional | 56 · Pre-op care only | $26.30 | $26.30 | $26.30 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | 59 · Distinct service | $251.19 | $251.19 | $251.19 |
Where Alabama sits
The same service costs 3.2 times more in Alaska than in Connecticut. 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· 25th of 51
$214
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.