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 Facility Modifier None Typical Low $41.69 Median $50.12 Typical High $50.12 | Facility | None | $41.69 | $50.12 | $50.12 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $42.66 | Professional | None | $41.69 | $41.69 | $42.66 |
BCBS Alabama Setting Professional Modifier 12 Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | 12 | $41.69 | $41.69 | $41.69 |
Cigna Setting Facility Modifier None Typical Low $41.69 Median $42.66 Typical High $67.61 | Facility | None | $41.69 | $42.66 | $67.61 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $354.81 | Professional | None | $41.69 | $41.69 | $354.81 |
United Setting Facility Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Facility | None | $41.69 | $41.69 | $41.69 |
United Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $52.48 | Professional | None | $50.12 | $50.12 | $52.48 |
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 $20.89 Median $20.89 Typical High $20.89 | Professional | 52 · Reduced service | $20.89 | $20.89 | $20.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $8.32 Typical High $8.32 | Professional | 53 · Discontinued | $8.32 | $8.32 | $8.32 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $6.17 Typical High $6.17 | Professional | 55 · Aftercare only | $6.17 | $6.17 | $6.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $4.17 Typical High $4.17 | Professional | 56 · Pre-op care only | $4.17 | $4.17 | $4.17 |
Where Alabama sits
The same service costs 3.9 times more in Wyoming than in Georgia. 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· 49th of 51
$42.66
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.