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 $562.34 Median $954.99 Typical High $2,398.83 | Facility | None | $562.34 | $954.99 | $2,398.83 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $131.83 Typical High $151.36 | Professional | None | $72.44 | $131.83 | $151.36 |
BCBS Alabama Setting Facility Modifier None Typical Low $436.52 Median $446.68 Typical High $446.68 | Facility | None | $436.52 | $446.68 | $446.68 |
BCBS Alabama Setting Professional Modifier None Typical Low $117.49 Median $162.18 Typical High $181.97 | Professional | None | $117.49 | $162.18 | $181.97 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $147.91 Typical High $239.88 | Professional | None | $87.10 | $147.91 | $239.88 |
United Setting Facility Modifier None Typical Low $251.19 Median $870.96 Typical High $1,737.80 | Facility | None | $251.19 | $870.96 | $1,737.80 |
United Setting Professional Modifier None Typical Low $69.18 Median $144.54 Typical High $229.09 | Professional | None | $69.18 | $144.54 | $229.09 |
6 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 $36.31 Median $66.07 Typical High $75.86 | Professional | 52 · Reduced service | $36.31 | $66.07 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $26.30 Typical High $30.20 | Professional | 53 · Discontinued | $14.45 | $26.30 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $54.95 Median $100.00 Typical High $112.20 | Professional | 54 · Surgery only | $54.95 | $100.00 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $19.95 Typical High $22.91 | Professional | 55 · Aftercare only | $10.96 | $19.95 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $13.18 Typical High $15.14 | Professional | 56 · Pre-op care only | $7.24 | $13.18 | $15.14 |
BCBS Alabama Setting Facility Modifier 50 · Both sides Typical Low $660.69 Median $660.69 Typical High $660.69 | Facility | 50 · Both sides | $660.69 | $660.69 | $660.69 |
Where Alabama sits
The same service costs 2.6 times more in Wisconsin than in Utah. 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· 34th of 51
$151
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.