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 $100.00 Median $114.82 Typical High $177.83 | Professional | None | $100.00 | $114.82 | $177.83 |
BCBS Alabama Setting Facility Modifier None Typical Low $1,318.26 Median $1,348.96 Typical High $1,348.96 | Facility | None | $1,318.26 | $1,348.96 | $1,348.96 |
BCBS Alabama Setting Professional Modifier 32 · Mandated service Typical Low $77.62 Median $107.15 Typical High $158.49 | Professional | 32 · Mandated service | $77.62 | $107.15 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $79.43 Median $97.72 Typical High $501.19 | Facility | None | $79.43 | $97.72 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $93.33 Typical High $151.36 | Professional | None | $60.26 | $93.33 | $151.36 |
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 $48.98 Median $89.13 Typical High $162.18 | Professional | None | $48.98 | $89.13 | $162.18 |
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 $50.12 Median $60.26 Typical High $89.13 | Professional | 52 · Reduced service | $50.12 | $60.26 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $23.99 Typical High $35.48 | Professional | 53 · Discontinued | $19.95 | $23.99 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $89.13 Typical High $131.83 | Professional | 54 · Surgery only | $75.86 | $89.13 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $18.20 Typical High $26.92 | Professional | 55 · Aftercare only | $15.14 | $18.20 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $12.02 Typical High $17.78 | Professional | 56 · Pre-op care only | $10.00 | $12.02 | $17.78 |
Where Alabama sits
The same service costs 3.9 times more in Wisconsin than in Kentucky. 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· 18th 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.