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 $891.25 Median $1,348.96 Typical High $2,398.83 | Facility | None | $891.25 | $1,348.96 | $2,398.83 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,318.26 | $1,318.26 | $1,318.26 |
BCBS Alabama Setting Facility Modifier None Typical Low $5,370.32 Median $5,495.41 Typical High $5,495.41 | Facility | None | $5,370.32 | $5,495.41 | $5,495.41 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $7,244.36 Typical High $8,912.51 | Facility | None | $549.54 | $7,244.36 | $8,912.51 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $3,801.89 Typical High $8,511.38 | Facility | None | $1,513.56 | $3,801.89 | $8,511.38 |
United Setting Professional Modifier None Typical Low $1,202.26 Median $1,548.82 Typical High $2,511.89 | Professional | None | $1,202.26 | $1,548.82 | $2,511.89 |
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 $660.69 Median $660.69 Typical High $660.69 | Professional | 52 · Reduced service | $660.69 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | 53 · Discontinued | $263.03 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $977.24 Typical High $977.24 | Professional | 54 · Surgery only | $977.24 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | 55 · Aftercare only | $194.98 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | 56 · Pre-op care only | $131.83 | $131.83 | $131.83 |
Where Alabama sits
The same service costs 4.9 times more in Alaska than in Indiana. 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· 34th of 51
$2,344
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.