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 $53.70 Median $53.70 Typical High $56.23 | Professional | None | $53.70 | $53.70 | $56.23 |
Ambetter Setting Professional Modifier None Typical Low $16.98 Median $16.98 Typical High $53.70 | Professional | None | $16.98 | $16.98 | $53.70 |
BCBS Alabama Setting Professional Modifier 12 Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | 12 | $53.70 | $53.70 | $53.70 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $54.95 Typical High $69.18 | Facility | None | $53.70 | $54.95 | $69.18 |
Cigna Setting Professional Modifier None Typical Low $37.15 Median $53.70 Typical High $53.70 | Professional | None | $37.15 | $53.70 | $53.70 |
United Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $51.29 | Professional | None | $51.29 | $51.29 | $51.29 |
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 $26.92 Median $26.92 Typical High $26.92 | Professional | 52 · Reduced service | $26.92 | $26.92 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $10.72 Typical High $10.72 | Professional | 53 · Discontinued | $10.72 | $10.72 | $10.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | 55 · Aftercare only | $8.13 | $8.13 | $8.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $5.37 Typical High $5.37 | Professional | 56 · Pre-op care only | $5.37 | $5.37 | $5.37 |
Where Alabama sits
The same service costs 3.0 times more in Arizona than in Oklahoma. 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· 23rd of 51
$53.70
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.