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 $53.70 Median $53.70 Typical High $53.70 | Professional | None | $53.70 | $53.70 | $53.70 |
BCBS Alabama Setting Facility Modifier None Typical Low $213.80 Median $218.78 Typical High $218.78 | Facility | None | $213.80 | $218.78 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $54.95 Typical High $70.79 | Facility | None | $53.70 | $54.95 | $70.79 |
Cigna Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $91.20 | Professional | None | $53.70 | $53.70 | $91.20 |
United Setting Facility Modifier None Typical Low $39.81 Median $41.69 Typical High $54.95 | Facility | None | $39.81 | $41.69 | $54.95 |
United Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | None | $52.48 | $52.48 | $52.48 |
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 $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 |
BCBS Alabama Setting Professional Modifier 12 Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | 12 | $52.48 | $52.48 | $52.48 |
Where Alabama sits
The same service costs 6.6 times more in Alabama than in Kansas. 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· 1st 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.