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 $229.09 Median $251.19 Typical High $436.52 | Professional | None | $229.09 | $251.19 | $436.52 |
BCBS Alabama Setting Facility Modifier None Typical Low $1,096.48 Median $1,122.02 Typical High $1,122.02 | Facility | None | $1,096.48 | $1,122.02 | $1,122.02 |
BCBS Alabama Setting Professional Modifier None Typical Low $208.93 Median $281.84 Typical High $389.05 | Professional | None | $208.93 | $281.84 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $204.17 Median $251.19 Typical High $630.96 | Facility | None | $204.17 | $251.19 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $263.03 Typical High $338.84 | Professional | None | $154.88 | $263.03 | $338.84 |
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 $114.82 Median $208.93 Typical High $380.19 | Professional | None | $114.82 | $208.93 | $380.19 |
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 $112.20 Median $151.36 Typical High $218.78 | Professional | 52 · Reduced service | $112.20 | $151.36 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $60.26 Typical High $87.10 | Professional | 53 · Discontinued | $45.71 | $60.26 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $223.87 Typical High $331.13 | Professional | 54 · Surgery only | $169.82 | $223.87 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $44.67 Typical High $66.07 | Professional | 55 · Aftercare only | $33.88 | $44.67 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $30.20 Typical High $43.65 | Professional | 56 · Pre-op care only | $22.91 | $30.20 | $43.65 |
BCBS Alabama Setting Facility Modifier 50 · Both sides Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Facility | 50 · Both sides | $1,659.59 | $1,659.59 | $1,659.59 |
Where Alabama sits
The same service costs 3.2 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· 26th of 51
$282
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.