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 $18.62 Median $18.62 Typical High $18.62 | Professional | None | $18.62 | $18.62 | $18.62 |
BCBS Alabama Setting Facility Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $2,511.89 | Facility | None | $2,511.89 | $2,511.89 | $2,511.89 |
BCBS Alabama Setting Professional Modifier None Typical Low $11.75 Median $16.22 Typical High $16.22 | Professional | None | $11.75 | $16.22 | $16.22 |
Cigna Setting Facility Modifier None Typical Low $309.03 Median $407.38 Typical High $758.58 | Facility | None | $309.03 | $407.38 | $758.58 |
Cigna Setting Professional Modifier None Typical Low $12.88 Median $13.49 Typical High $19.05 | Professional | None | $12.88 | $13.49 | $19.05 |
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 $9.55 Median $12.02 Typical High $19.50 | Professional | None | $9.55 | $12.02 | $19.50 |
4 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 $9.33 Median $9.33 Typical High $9.33 | Professional | 52 · Reduced service | $9.33 | $9.33 | $9.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.72 Median $3.72 Typical High $3.72 | Professional | 53 · Discontinued | $3.72 | $3.72 | $3.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.75 Median $2.75 Typical High $2.75 | Professional | 55 · Aftercare only | $2.75 | $2.75 | $2.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.86 Median $1.86 Typical High $1.86 | Professional | 56 · Pre-op care only | $1.86 | $1.86 | $1.86 |
Where Alabama sits
The same service costs 12.3 times more in Florida than in Kentucky. 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· 30th of 51
$18.62
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.