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 $489.78 Median $933.25 Typical High $1,862.09 | Facility | None | $489.78 | $933.25 | $1,862.09 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $87.10 Typical High $194.98 | Professional | None | $60.26 | $87.10 | $194.98 |
BCBS Alabama Setting Facility Modifier None Typical Low $1,318.26 Median $1,348.96 Typical High $1,348.96 | Facility | None | $1,318.26 | $1,348.96 | $1,348.96 |
BCBS Alabama Setting Professional Modifier 32 · Mandated service Typical Low $70.79 Median $95.50 Typical High $134.90 | Professional | 32 · Mandated service | $70.79 | $95.50 | $134.90 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $93.33 Typical High $446.68 | Facility | None | $50.12 | $93.33 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $102.33 Typical High $194.98 | Professional | None | $38.02 | $102.33 | $194.98 |
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 $26.30 Median $74.13 Typical High $162.18 | Professional | None | $26.30 | $74.13 | $162.18 |
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 $30.20 Median $43.65 Typical High $97.72 | Professional | 52 · Reduced service | $30.20 | $43.65 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $17.38 Typical High $38.90 | Professional | 53 · Discontinued | $12.02 | $17.38 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $44.67 Median $64.57 Typical High $144.54 | Professional | 54 · Surgery only | $44.67 | $64.57 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $12.88 Typical High $28.84 | Professional | 55 · Aftercare only | $8.91 | $12.88 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $8.71 Typical High $19.50 | Professional | 56 · Pre-op care only | $6.03 | $8.71 | $19.50 |
Where Alabama sits
The same service costs 5.4 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· 15th of 51
$120
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.