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 $645.65 Median $1,230.27 Typical High $2,398.83 | Facility | None | $645.65 | $1,230.27 | $2,398.83 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
BCBS Alabama Setting Facility Modifier None Typical Low $269.15 Median $275.42 Typical High $275.42 | Facility | None | $269.15 | $275.42 | $275.42 |
BCBS Alabama Setting Professional Modifier 12 + 32 · Mandated service Typical Low $208.93 Median $239.88 Typical High $309.03 | Professional | 12 + 32 · Mandated service | $208.93 | $239.88 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $104.71 Median $128.82 Typical High $630.96 | Facility | None | $104.71 | $128.82 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $194.98 Typical High $281.84 | Professional | None | $158.49 | $194.98 | $281.84 |
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 $138.04 Median $173.78 Typical High $323.59 | Professional | None | $138.04 | $173.78 | $323.59 |
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 $83.18 Median $83.18 Typical High $83.18 | Professional | 52 · Reduced service | $83.18 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | 53 · Discontinued | $33.11 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | 54 · Surgery only | $123.03 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | 55 · Aftercare only | $24.55 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $16.60 Typical High $16.60 | Professional | 56 · Pre-op care only | $16.60 | $16.60 | $16.60 |
Where Alabama sits
The same service costs 4.1 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· 38th of 51
$214
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.