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 $977.24 Median $977.24 Typical High $977.24 | Professional | None | $977.24 | $977.24 | $977.24 |
BCBS Alabama Setting Facility Modifier None Typical Low $12,589.25 Median $12,589.25 Typical High $12,589.25 | Facility | None | $12,589.25 | $12,589.25 | $12,589.25 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $851.14 Typical High $4,786.30 | Facility | None | $478.63 | $851.14 | $4,786.30 |
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 $912.01 Median $1,202.26 Typical High $1,621.81 | Professional | None | $912.01 | $1,202.26 | $1,621.81 |
4 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 $489.78 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $489.78 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $194.98 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | 55 · Aftercare only | $147.91 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $97.72 | $97.72 | $97.72 |
Where Alabama sits
The same service costs 18.2 times more in California 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
$4,266
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.