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 Facility Modifier None Typical Low $794.33 Median $1,737.80 Typical High $3,630.78 | Facility | None | $794.33 | $1,737.80 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | None | $331.13 | $331.13 | $331.13 |
BCBS Alabama Setting Facility Modifier None Typical Low $2,454.71 Median $2,511.89 Typical High $2,511.89 | Facility | None | $2,454.71 | $2,511.89 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $6,760.83 Typical High $8,511.38 | Facility | None | $549.54 | $6,760.83 | $8,511.38 |
United Setting Facility Modifier None Typical Low $1,584.89 Median $5,128.61 Typical High $10,964.78 | Facility | None | $1,584.89 | $5,128.61 | $10,964.78 |
United Setting Professional Modifier None Typical Low $41.69 Median $53.70 Typical High $81.28 | Professional | None | $41.69 | $53.70 | $81.28 |
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 $165.96 Median $165.96 Typical High $165.96 | Professional | 52 · Reduced service | $165.96 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | 53 · Discontinued | $66.07 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | 54 · Surgery only | $245.47 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | 55 · Aftercare only | $48.98 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | 56 · Pre-op care only | $33.11 | $33.11 | $33.11 |
Where Alabama sits
The same service costs 93.3 times more in Oregon than in Vermont. 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· 18th of 51
$2,455
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.