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 $645.65 Median $1,659.59 Typical High $3,311.31 | Professional | None | $645.65 | $1,659.59 | $3,311.31 |
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 $1,548.82 Median $2,137.96 Typical High $2,818.38 | Professional | None | $1,548.82 | $2,137.96 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $707.95 Typical High $2,884.03 | Professional | None | $389.05 | $707.95 | $2,884.03 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $5,128.61 Typical High $8,912.51 | Facility | None | $1,513.56 | $5,128.61 | $8,912.51 |
United Setting Professional Modifier None Typical Low $338.84 Median $1,862.09 Typical High $2,818.38 | Professional | None | $338.84 | $1,862.09 | $2,818.38 |
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 $323.59 Median $831.76 Typical High $1,659.59 | Professional | 52 · Reduced service | $323.59 | $831.76 | $1,659.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $331.13 Typical High $660.69 | Professional | 53 · Discontinued | $128.82 | $331.13 | $660.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $1,230.27 Typical High $2,511.89 | Professional | 54 · Surgery only | $478.63 | $1,230.27 | $2,511.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $245.47 Typical High $501.19 | Professional | 55 · Aftercare only | $95.50 | $245.47 | $501.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $165.96 Typical High $331.13 | Professional | 56 · Pre-op care only | $64.57 | $165.96 | $331.13 |
Where Alabama sits
The same service costs 6.9 times more in Wisconsin than in Hawaii. 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· 18th of 51
$2,138
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.