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 $562.34 Median $954.99 Typical High $2,398.83 | Facility | None | $562.34 | $954.99 | $2,398.83 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | None | $269.15 | $269.15 | $269.15 |
BCBS Alabama Setting Facility Modifier None Typical Low $1,380.38 Median $1,412.54 Typical High $1,412.54 | Facility | None | $1,380.38 | $1,412.54 | $1,412.54 |
BCBS Alabama Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | None | $489.78 | $489.78 | $489.78 |
BCBS Alabama Setting Professional Modifier 32 · Mandated service Typical Low $151.36 Median $186.21 Typical High $251.19 | Professional | 32 · Mandated service | $151.36 | $186.21 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $851.14 Typical High $1,047.13 | Facility | None | $363.08 | $851.14 | $1,047.13 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $208.93 | Professional | None | $162.18 | $162.18 | $208.93 |
United Setting Facility Modifier None Typical Low $467.74 Median $1,000.00 Typical High $3,162.28 | Facility | None | $467.74 | $1,000.00 | $3,162.28 |
United Setting Professional Modifier None Typical Low $102.33 Median $131.83 Typical High $281.84 | Professional | None | $102.33 | $131.83 | $281.84 |
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 $134.90 Median $134.90 Typical High $134.90 | Professional | 52 · Reduced service | $134.90 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | 53 · Discontinued | $54.95 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | 54 · Surgery only | $204.17 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | 55 · Aftercare only | $40.74 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | 56 · Pre-op care only | $26.92 | $26.92 | $26.92 |
Where Alabama sits
The same service costs 5.4 times more in Alaska than in Utah. 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· 26th of 51
$209
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.