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 $48.98 Median $57.54 Typical High $77.62 | Professional | None | $48.98 | $57.54 | $77.62 |
BCBS Alabama Setting Facility Modifier None Typical Low $645.65 Median $645.65 Typical High $645.65 | Facility | None | $645.65 | $645.65 | $645.65 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 Typical Low $47.86 Median $66.07 Typical High $74.13 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 | $47.86 | $66.07 | $74.13 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $58.88 Typical High $446.68 | Facility | None | $50.12 | $58.88 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $57.54 Typical High $72.44 | Professional | None | $48.98 | $57.54 | $72.44 |
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 $43.65 Median $63.10 Typical High $89.13 | Professional | None | $43.65 | $63.10 | $89.13 |
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 $24.55 Median $28.84 Typical High $38.90 | Professional | 52 · Reduced service | $24.55 | $28.84 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $11.48 Typical High $15.49 | Professional | 53 · Discontinued | $9.77 | $11.48 | $15.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $37.15 Median $42.66 Typical High $57.54 | Professional | 54 · Surgery only | $37.15 | $42.66 | $57.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $8.51 Typical High $11.48 | Professional | 55 · Aftercare only | $7.41 | $8.51 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $5.75 Typical High $7.76 | Professional | 56 · Pre-op care only | $4.90 | $5.75 | $7.76 |
Where Alabama sits
The same service costs 3.4 times more in Alaska than in New York. 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· 43rd of 51
$72.44
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.