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 $562.34 Median $954.99 Typical High $2,398.83 | Facility | None | $562.34 | $954.99 | $2,398.83 |
Aetna Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Professional | None | $2,454.71 | $2,454.71 | $2,454.71 |
BCBS Alabama Setting Facility Modifier None Typical Low $1,318.26 Median $1,348.96 Typical High $1,348.96 | Facility | None | $1,318.26 | $1,348.96 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $758.58 Typical High $1,230.27 | Facility | None | $549.54 | $758.58 | $1,230.27 |
United Setting Facility Modifier None Typical Low $478.63 Median $1,000.00 Typical High $3,162.28 | Facility | None | $478.63 | $1,000.00 | $3,162.28 |
United Setting Professional Modifier None Typical Low $2,818.38 Median $3,548.13 Typical High $5,754.40 | Professional | None | $2,818.38 | $3,548.13 | $5,754.40 |
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 $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | 52 · Reduced service | $1,230.27 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | 53 · Discontinued | $489.78 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Professional | 54 · Surgery only | $1,819.70 | $1,819.70 | $1,819.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | 55 · Aftercare only | $363.08 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | 56 · Pre-op care only | $245.47 | $245.47 | $245.47 |
Where Alabama sits
The same service costs 3.5 times more in Indiana than in Maryland. 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· 47th of 51
$1,905
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.