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 Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | None | $64.57 | $64.57 | $64.57 |
BCBS Alabama Setting Professional Modifier 12 Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | 12 | $56.23 | $56.23 | $56.23 |
Cigna Setting Facility Modifier None Typical Low $54.95 Median $56.23 Typical High $70.79 | Facility | None | $54.95 | $56.23 | $70.79 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $89.13 | Professional | None | $54.95 | $54.95 | $89.13 |
United Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | None | $56.23 | $56.23 | $56.23 |
4 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 $32.36 Median $32.36 Typical High $32.36 | Professional | 52 · Reduced service | $32.36 | $32.36 | $32.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $12.88 Typical High $12.88 | Professional | 53 · Discontinued | $12.88 | $12.88 | $12.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $9.55 Typical High $9.55 | Professional | 55 · Aftercare only | $9.55 | $9.55 | $9.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $6.46 Typical High $6.46 | Professional | 56 · Pre-op care only | $6.46 | $6.46 | $6.46 |
Where Alabama sits
The same service costs 1.6 times more in Arizona 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· 32nd of 51
$56.23
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.