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 $57.54 Median $104.71 Typical High $141.25 | Professional | None | $57.54 | $104.71 | $141.25 |
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 $34.67 Median $47.86 Typical High $87.10 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 41 | $34.67 | $47.86 | $87.10 |
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 $58.88 Median $104.71 Typical High $128.82 | Professional | None | $58.88 | $104.71 | $128.82 |
United Setting Facility Modifier None Typical Low $100.00 Median $363.08 Typical High $1,380.38 | Facility | None | $100.00 | $363.08 | $1,380.38 |
United Setting Professional Modifier None Typical Low $51.29 Median $100.00 Typical High $138.04 | Professional | None | $51.29 | $100.00 | $138.04 |
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 $28.84 Median $54.95 Typical High $63.10 | Professional | 52 · Reduced service | $28.84 | $54.95 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $21.88 Typical High $25.12 | Professional | 53 · Discontinued | $11.48 | $21.88 | $25.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $42.66 Median $83.18 Typical High $95.50 | Professional | 54 · Surgery only | $42.66 | $83.18 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $16.60 Typical High $19.05 | Professional | 55 · Aftercare only | $8.71 | $16.60 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $10.96 Typical High $12.59 | Professional | 56 · Pre-op care only | $5.75 | $10.96 | $12.59 |
Where Alabama sits
The same service costs 3.5 times more in Alaska than in New Jersey. 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· 21st of 51
$126
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.