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 $43.65 Median $75.86 Typical High $112.20 | Professional | None | $43.65 | $75.86 | $112.20 |
Ambetter Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | None | $91.20 | $91.20 | $91.20 |
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 $41.69 Median $57.54 Typical High $64.57 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 41 | $41.69 | $57.54 | $64.57 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $87.10 Typical High $446.68 | Facility | None | $50.12 | $87.10 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $83.18 Typical High $104.71 | Professional | None | $44.67 | $83.18 | $104.71 |
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 $38.90 Median $77.62 Typical High $112.20 | Professional | None | $38.90 | $77.62 | $112.20 |
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 $21.88 Median $42.66 Typical High $52.48 | Professional | 52 · Reduced service | $21.88 | $42.66 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $17.38 Typical High $20.89 | Professional | 53 · Discontinued | $8.71 | $17.38 | $20.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $32.36 Median $64.57 Typical High $79.43 | Professional | 54 · Surgery only | $32.36 | $64.57 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $12.88 Typical High $15.85 | Professional | 55 · Aftercare only | $6.46 | $12.88 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $8.71 Typical High $10.47 | Professional | 56 · Pre-op care only | $4.37 | $8.71 | $10.47 |
Where Alabama sits
The same service costs 3.5 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· 20th of 51
$105
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.