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 $70.79 Median $114.82 Typical High $158.49 | Professional | None | $70.79 | $114.82 | $158.49 |
Ambetter Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | None | $67.61 | $67.61 | $67.61 |
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 $70.79 Median $95.50 Typical High $107.15 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 41 | $70.79 | $95.50 | $107.15 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $104.71 Typical High $446.68 | Facility | None | $50.12 | $104.71 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $117.49 Typical High $147.91 | Professional | None | $72.44 | $117.49 | $147.91 |
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 $63.10 Median $112.20 Typical High $154.88 | Professional | None | $63.10 | $112.20 | $154.88 |
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 $35.48 Median $61.66 Typical High $72.44 | Professional | 52 · Reduced service | $35.48 | $61.66 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $24.55 Typical High $28.84 | Professional | 53 · Discontinued | $14.45 | $24.55 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $53.70 Median $93.33 Typical High $107.15 | Professional | 54 · Surgery only | $53.70 | $93.33 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $18.62 Typical High $21.38 | Professional | 55 · Aftercare only | $10.72 | $18.62 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $12.30 Typical High $14.45 | Professional | 56 · Pre-op care only | $7.08 | $12.30 | $14.45 |
Where Alabama sits
The same service costs 3.2 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· 18th of 51
$145
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.