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 $1,513.56 Typical High $2,398.83 | Facility | None | $794.33 | $1,513.56 | $2,398.83 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | None | $457.09 | $457.09 | $457.09 |
BCBS Alabama Setting Facility Modifier None Typical Low $12,022.64 Median $12,022.64 Typical High $12,022.64 | Facility | None | $12,022.64 | $12,022.64 | $12,022.64 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $18,197.01 Typical High $22,387.21 | Facility | None | $549.54 | $18,197.01 | $22,387.21 |
United Setting Facility Modifier None Typical Low $2,511.89 Median $12,302.69 Typical High $26,915.35 | Facility | None | $2,511.89 | $12,302.69 | $26,915.35 |
United Setting Professional Modifier None Typical Low $407.38 Median $537.03 Typical High $724.44 | Professional | None | $407.38 | $537.03 | $724.44 |
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 $229.09 Median $229.09 Typical High $229.09 | Professional | 52 · Reduced service | $229.09 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | 53 · Discontinued | $91.20 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | 54 · Surgery only | $338.84 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | 55 · Aftercare only | $67.61 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | 56 · Pre-op care only | $45.71 | $45.71 | $45.71 |
Where Alabama sits
The same service costs 29.5 times more in Louisiana than in Maine. 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· 3rd of 51
$11,482
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.