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 Professional Modifier None Typical Low $16.60 Median $25.70 Typical High $54.95 | Professional | None | $16.60 | $25.70 | $54.95 |
BCBS Alabama Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Facility | None | $85.11 | $85.11 | $85.11 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery Typical Low $9.77 Median $13.18 Typical High $13.49 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery | $9.77 | $13.18 | $13.49 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $512.86 Typical High $977.24 | Facility | None | $446.68 | $512.86 | $977.24 |
Cigna Setting Professional Modifier None Typical Low $12.30 Median $29.51 Typical High $51.29 | Professional | None | $12.30 | $29.51 | $51.29 |
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 $7.94 Median $21.38 Typical High $32.36 | Professional | None | $7.94 | $21.38 | $32.36 |
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 $8.32 Median $14.79 Typical High $27.54 | Professional | 52 · Reduced service | $8.32 | $14.79 | $27.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.31 Median $5.89 Typical High $10.96 | Professional | 53 · Discontinued | $3.31 | $5.89 | $10.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $12.59 Median $22.39 Typical High $40.74 | Professional | 54 · Surgery only | $12.59 | $22.39 | $40.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.51 Median $4.47 Typical High $8.13 | Professional | 55 · Aftercare only | $2.51 | $4.47 | $8.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.66 Median $2.95 Typical High $5.50 | Professional | 56 · Pre-op care only | $1.66 | $2.95 | $5.50 |
Where Alabama sits
The same service costs 4.2 times more in Wisconsin than in Nebraska. 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· 8th of 51
$41.69
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.