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 $54.95 Median $54.95 Typical High $54.95 | Professional | None | $54.95 | $54.95 | $54.95 |
BCBS Alabama Setting Professional Modifier 12 Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | 12 | $54.95 | $54.95 | $54.95 |
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 $158.49 | Professional | None | $54.95 | $54.95 | $158.49 |
United Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | None | $54.95 | $54.95 | $54.95 |
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 $27.54 Median $27.54 Typical High $27.54 | Professional | 52 · Reduced service | $27.54 | $27.54 | $27.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $10.96 Typical High $10.96 | Professional | 53 · Discontinued | $10.96 | $10.96 | $10.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $8.32 Typical High $8.32 | Professional | 55 · Aftercare only | $8.32 | $8.32 | $8.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $5.50 Typical High $5.50 | Professional | 56 · Pre-op care only | $5.50 | $5.50 | $5.50 |
Where Alabama sits
The same service costs 2.7 times more in Oklahoma than in West Virginia. 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· 35th of 51
$54.95
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.