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 $776.25 Median $1,258.93 Typical High $2,398.83 | Facility | None | $776.25 | $1,258.93 | $2,398.83 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | None | $288.40 | $288.40 | $288.40 |
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 21 + 22 · Increased work + 24 · Unrelated visit after surgery Typical Low $251.19 Median $302.00 Typical High $416.87 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery | $251.19 | $302.00 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $1,174.90 Median $2,398.83 Typical High $3,388.44 | Facility | None | $1,174.90 | $2,398.83 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $223.87 Typical High $436.52 | Professional | None | $204.17 | $223.87 | $436.52 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $3,090.30 Typical High $6,309.57 | Facility | None | $1,202.26 | $3,090.30 | $6,309.57 |
United Setting Professional Modifier None Typical Low $154.88 Median $199.53 Typical High $295.12 | Professional | None | $154.88 | $199.53 | $295.12 |
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 $144.54 Median $144.54 Typical High $144.54 | Professional | 52 · Reduced service | $144.54 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | 53 · Discontinued | $57.54 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | 54 · Surgery only | $218.78 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | 55 · Aftercare only | $43.65 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | 56 · Pre-op care only | $28.84 | $28.84 | $28.84 |
Where Alabama sits
The same service costs 10.2 times more in Oklahoma 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· 10th of 51
$437
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.