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 $186.21 Median $891.25 Typical High $1,862.09 | Facility | None | $186.21 | $891.25 | $1,862.09 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $186.21 Typical High $186.21 | Professional | None | $120.23 | $186.21 | $186.21 |
BCBS Alabama Setting Facility Modifier None Typical Low $14,791.08 Median $15,135.61 Typical High $15,135.61 | Facility | None | $14,791.08 | $15,135.61 | $15,135.61 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 Typical Low $169.82 Median $213.80 Typical High $295.12 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 | $169.82 | $213.80 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $616.60 Typical High $977.24 | Facility | None | $478.63 | $616.60 | $977.24 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $144.54 Typical High $323.59 | Professional | None | $123.03 | $144.54 | $323.59 |
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 $93.33 Median $114.82 Typical High $177.83 | Professional | None | $93.33 | $114.82 | $177.83 |
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 $93.33 Median $93.33 Typical High $93.33 | Professional | 52 · Reduced service | $93.33 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | 53 · Discontinued | $37.15 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | 54 · Surgery only | $141.25 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | 55 · Aftercare only | $28.18 | $28.18 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $18.62 Typical High $18.62 | Professional | 56 · Pre-op care only | $18.62 | $18.62 | $18.62 |
Where Alabama sits
The same service costs 4.0 times more in Alaska than in Delaware. 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· 16th of 51
$186
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.