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 $501.19 Median $1,122.02 Typical High $2,089.30 | Professional | None | $501.19 | $1,122.02 | $2,089.30 |
BCBS Alabama Setting Facility Modifier None Typical Low $6,025.60 Median $6,025.60 Typical High $6,025.60 | Facility | None | $6,025.60 | $6,025.60 | $6,025.60 |
BCBS Alabama Setting Professional Modifier None Typical Low $1,023.29 Median $1,412.54 Typical High $1,778.28 | Professional | None | $1,023.29 | $1,412.54 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $724.44 Typical High $1,737.80 | Professional | None | $295.12 | $724.44 | $1,737.80 |
United Setting Facility Modifier None Typical Low $1,096.48 Median $3,467.37 Typical High $5,370.32 | Facility | None | $1,096.48 | $3,467.37 | $5,370.32 |
United Setting Professional Modifier None Typical Low $263.03 Median $1,071.52 Typical High $1,659.59 | Professional | None | $263.03 | $1,071.52 | $1,659.59 |
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 $251.19 Median $562.34 Typical High $1,023.29 | Professional | 52 · Reduced service | $251.19 | $562.34 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $223.87 Typical High $416.87 | Professional | 53 · Discontinued | $100.00 | $223.87 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $851.14 Typical High $1,548.82 | Professional | 54 · Surgery only | $380.19 | $851.14 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $169.82 Typical High $309.03 | Professional | 55 · Aftercare only | $75.86 | $169.82 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $112.20 Typical High $208.93 | Professional | 56 · Pre-op care only | $50.12 | $112.20 | $208.93 |
BCBS Alabama Setting Facility Modifier 50 · Both sides Typical Low $8,912.51 Median $9,120.11 Typical High $9,120.11 | Facility | 50 · Both sides | $8,912.51 | $9,120.11 | $9,120.11 |
Where Alabama sits
The same service costs 5.1 times more in Wisconsin than in Maryland. 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· 12th of 51
$1,413
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.