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 $954.99 Median $1,778.28 Typical High $2,754.23 | Facility | None | $954.99 | $1,778.28 | $2,754.23 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | None | $380.19 | $380.19 | $380.19 |
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 $14,125.38 Typical High $17,782.79 | Facility | None | $549.54 | $14,125.38 | $17,782.79 |
United Setting Facility Modifier None Typical Low $1,584.89 Median $5,128.61 Typical High $11,481.54 | Facility | None | $1,584.89 | $5,128.61 | $11,481.54 |
United Setting Professional Modifier None Typical Low $478.63 Median $645.65 Typical High $891.25 | Professional | None | $478.63 | $645.65 | $891.25 |
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 $190.55 Median $190.55 Typical High $190.55 | Professional | 52 · Reduced service | $190.55 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | 53 · Discontinued | $75.86 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $281.84 Typical High $288.40 | Professional | 54 · Surgery only | $281.84 | $281.84 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $56.23 Typical High $57.54 | Professional | 55 · Aftercare only | $56.23 | $56.23 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | 56 · Pre-op care only | $38.02 | $38.02 | $38.02 |
Where Alabama sits
The same service costs 27.5 times more in Oklahoma than in New York. 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· 7th of 51
$4,677
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.