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 $97.72 Median $114.82 Typical High $138.04 | Professional | None | $97.72 | $114.82 | $138.04 |
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 $95.50 Median $128.82 Typical High $144.54 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 | $95.50 | $128.82 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $95.50 Typical High $446.68 | Facility | None | $50.12 | $95.50 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $97.72 Typical High $125.89 | Professional | None | $91.20 | $97.72 | $125.89 |
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 $87.10 Median $114.82 Typical High $165.96 | Professional | None | $87.10 | $114.82 | $165.96 |
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 $47.86 Median $57.54 Typical High $69.18 | Professional | 52 · Reduced service | $47.86 | $57.54 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $22.91 Typical High $27.54 | Professional | 53 · Discontinued | $19.50 | $22.91 | $27.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $87.10 Typical High $102.33 | Professional | 54 · Surgery only | $72.44 | $87.10 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $17.38 Typical High $20.42 | Professional | 55 · Aftercare only | $14.45 | $17.38 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $11.48 Typical High $13.80 | Professional | 56 · Pre-op care only | $9.77 | $11.48 | $13.80 |
Where Alabama sits
The same service costs 3.7 times more in Alaska than in Florida. 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· 45th 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.