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 $199.53 Median $269.15 Typical High $436.52 | Professional | None | $199.53 | $269.15 | $436.52 |
BCBS Alabama Setting Facility Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $2,818.38 | Facility | None | $2,818.38 | $2,818.38 | $2,818.38 |
BCBS Alabama Setting Professional Modifier None Typical Low $204.17 Median $281.84 Typical High $371.54 | Professional | None | $204.17 | $281.84 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $831.76 Typical High $1,096.48 | Facility | None | $489.78 | $831.76 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $223.87 Typical High $338.84 | Professional | None | $141.25 | $223.87 | $338.84 |
United Setting Facility Modifier None Typical Low $467.74 Median $1,000.00 Typical High $3,162.28 | Facility | None | $467.74 | $1,000.00 | $3,162.28 |
United Setting Professional Modifier None Typical Low $100.00 Median $204.17 Typical High $323.59 | Professional | None | $100.00 | $204.17 | $323.59 |
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 $100.00 Median $131.83 Typical High $218.78 | Professional | 52 · Reduced service | $100.00 | $131.83 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $53.70 Typical High $87.10 | Professional | 53 · Discontinued | $39.81 | $53.70 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $199.53 Typical High $323.59 | Professional | 54 · Surgery only | $151.36 | $199.53 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $39.81 Typical High $64.57 | Professional | 55 · Aftercare only | $30.20 | $39.81 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $26.92 Typical High $43.65 | Professional | 56 · Pre-op care only | $19.95 | $26.92 | $43.65 |
Where Alabama sits
The same service costs 3.9 times more in Alaska 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· 29th 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.