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 $776.25 Median $1,258.93 Typical High $2,630.27 | Facility | None | $776.25 | $1,258.93 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $32.36 Median $60.26 Typical High $93.33 | Professional | None | $32.36 | $60.26 | $93.33 |
Ambetter Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | None | $77.62 | $77.62 | $77.62 |
BCBS Alabama Setting Facility Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Facility | None | $239.88 | $239.88 | $239.88 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 41 Typical Low $19.50 Median $26.92 Typical High $47.86 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 41 | $19.50 | $26.92 | $47.86 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $102.33 Typical High $512.86 | Facility | None | $50.12 | $102.33 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $33.11 Median $70.79 Typical High $89.13 | Professional | None | $33.11 | $70.79 | $89.13 |
United Setting Facility Modifier None Typical Low $100.00 Median $371.54 Typical High $1,380.38 | Facility | None | $100.00 | $371.54 | $1,380.38 |
United Setting Professional Modifier None Typical Low $28.84 Median $60.26 Typical High $95.50 | Professional | None | $28.84 | $60.26 | $95.50 |
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 $16.22 Median $32.36 Typical High $45.71 | Professional | 52 · Reduced service | $16.22 | $32.36 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $12.88 Typical High $18.20 | Professional | 53 · Discontinued | $6.46 | $12.88 | $18.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $24.55 Median $47.86 Typical High $67.61 | Professional | 54 · Surgery only | $24.55 | $47.86 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.90 Median $9.77 Typical High $13.49 | Professional | 55 · Aftercare only | $4.90 | $9.77 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $6.46 Typical High $9.12 | Professional | 56 · Pre-op care only | $3.24 | $6.46 | $9.12 |
Where Alabama sits
The same service costs 3.3 times more in Alaska than in Kentucky. 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· 19th of 51
$89.13
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.