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 $162.18 Median $162.18 Typical High $426.58 | Professional | None | $162.18 | $162.18 | $426.58 |
BCBS Alabama Setting Facility Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Facility | None | $1,412.54 | $1,412.54 | $1,412.54 |
BCBS Alabama Setting Professional Modifier None Typical Low $158.49 Median $213.80 Typical High $316.23 | Professional | None | $158.49 | $213.80 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $501.19 Typical High $724.44 | Facility | None | $363.08 | $501.19 | $724.44 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $154.88 Typical High $239.88 | Professional | None | $89.13 | $154.88 | $239.88 |
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 $66.07 Median $151.36 Typical High $251.19 | Professional | None | $66.07 | $151.36 | $251.19 |
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 $81.28 Median $81.28 Typical High $213.80 | Professional | 52 · Reduced service | $81.28 | $81.28 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $32.36 Typical High $85.11 | Professional | 53 · Discontinued | $32.36 | $32.36 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $120.23 Typical High $316.23 | Professional | 54 · Surgery only | $120.23 | $120.23 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $23.99 Typical High $63.10 | Professional | 55 · Aftercare only | $23.99 | $23.99 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $16.22 Typical High $42.66 | Professional | 56 · Pre-op care only | $16.22 | $16.22 | $42.66 |
Where Alabama sits
The same service costs 4.1 times more in Alaska than in Washington, DC. 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
$186
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.