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 $69.18 Median $120.23 Typical High $141.25 | Professional | None | $69.18 | $120.23 | $141.25 |
Ambetter Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
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 $60.26 Median $83.18 Typical High $97.72 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 41 | $60.26 | $83.18 | $97.72 |
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 $69.18 Median $114.82 Typical High $141.25 | Professional | None | $69.18 | $114.82 | $141.25 |
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 $60.26 Median $109.65 Typical High $151.36 | Professional | None | $60.26 | $109.65 | $151.36 |
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 $33.88 Median $60.26 Typical High $70.79 | Professional | 52 · Reduced service | $33.88 | $60.26 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $23.99 Typical High $28.18 | Professional | 53 · Discontinued | $13.80 | $23.99 | $28.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $91.20 Typical High $104.71 | Professional | 54 · Surgery only | $51.29 | $91.20 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $18.20 Typical High $20.89 | Professional | 55 · Aftercare only | $10.23 | $18.20 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $12.02 Typical High $14.13 | Professional | 56 · Pre-op care only | $6.92 | $12.02 | $14.13 |
Where Alabama sits
The same service costs 3.5 times more in Alaska 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· 21st of 51
$141
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.