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 $457.09 Median $1,071.52 Typical High $2,137.96 | Professional | None | $457.09 | $1,071.52 | $2,137.96 |
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 $1,000.00 Median $1,380.38 Typical High $1,778.28 | Professional | None | $1,000.00 | $1,380.38 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $660.69 Typical High $1,819.70 | Professional | None | $275.42 | $660.69 | $1,819.70 |
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 $245.47 Median $1,174.90 Typical High $1,778.28 | Professional | None | $245.47 | $1,174.90 | $1,778.28 |
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 $229.09 Median $575.44 Typical High $1,071.52 | Professional | 52 · Reduced service | $229.09 | $575.44 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $229.09 Typical High $426.58 | Professional | 53 · Discontinued | $91.20 | $229.09 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $870.96 Typical High $1,584.89 | Professional | 54 · Surgery only | $338.84 | $870.96 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $173.78 Typical High $316.23 | Professional | 55 · Aftercare only | $67.61 | $173.78 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $114.82 Typical High $213.80 | Professional | 56 · Pre-op care only | $45.71 | $114.82 | $213.80 |
Where Alabama sits
The same service costs 4.7 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· 20th of 51
$1,380
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.