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 $16.60 Median $25.12 Typical High $28.18 | Professional | None | $16.60 | $25.12 | $28.18 |
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 Typical Low $17.78 Median $22.91 Typical High $25.12 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 | $17.78 | $22.91 | $25.12 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $446.68 Typical High $977.24 | Facility | None | $50.12 | $446.68 | $977.24 |
Cigna Setting Professional Modifier None Typical Low $16.60 Median $36.31 Typical High $44.67 | Professional | None | $16.60 | $36.31 | $44.67 |
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 $14.45 Median $30.20 Typical High $52.48 | Professional | None | $14.45 | $30.20 | $52.48 |
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 $8.32 Median $12.59 Typical High $14.13 | Professional | 52 · Reduced service | $8.32 | $12.59 | $14.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.31 Median $5.13 Typical High $5.62 | Professional | 53 · Discontinued | $3.31 | $5.13 | $5.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $12.30 Median $18.62 Typical High $21.38 | Professional | 54 · Surgery only | $12.30 | $18.62 | $21.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.45 Median $3.89 Typical High $4.27 | Professional | 55 · Aftercare only | $2.45 | $3.89 | $4.27 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.66 Median $2.51 Typical High $2.82 | Professional | 56 · Pre-op care only | $1.66 | $2.51 | $2.82 |
Where Alabama sits
The same service costs 3.9 times more in Alaska than in Hawaii. 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· 25th of 51
$36.31
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.