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 $562.34 Median $954.99 Typical High $2,398.83 | Facility | None | $562.34 | $954.99 | $2,398.83 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $489.78 Typical High $912.01 | Professional | None | $269.15 | $489.78 | $912.01 |
BCBS Alabama Setting Facility Modifier None Typical Low $912.01 Median $933.25 Typical High $933.25 | Facility | None | $912.01 | $933.25 | $933.25 |
BCBS Alabama Setting Professional Modifier None Typical Low $407.38 Median $562.34 Typical High $588.84 | Professional | None | $407.38 | $562.34 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $426.58 Typical High $812.83 | Professional | None | $208.93 | $426.58 | $812.83 |
United Setting Facility Modifier None Typical Low $251.19 Median $851.14 Typical High $1,698.24 | Facility | None | $251.19 | $851.14 | $1,698.24 |
United Setting Professional Modifier None Typical Low $134.90 Median $416.87 Typical High $645.65 | Professional | None | $134.90 | $416.87 | $645.65 |
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 $134.90 Median $245.47 Typical High $457.09 | Professional | 52 · Reduced service | $134.90 | $245.47 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $97.72 Typical High $181.97 | Professional | 53 · Discontinued | $53.70 | $97.72 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $371.54 Typical High $691.83 | Professional | 54 · Surgery only | $204.17 | $371.54 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $74.13 Typical High $138.04 | Professional | 55 · Aftercare only | $40.74 | $74.13 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $48.98 Typical High $91.20 | Professional | 56 · Pre-op care only | $26.92 | $48.98 | $91.20 |
BCBS Alabama Setting Facility Modifier 50 · Both sides Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Facility | 50 · Both sides | $1,380.38 | $1,380.38 | $1,380.38 |
Where Alabama sits
The same service costs 3.5 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· 13th of 51
$550
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.