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 $645.65 Median $1,230.27 Typical High $2,398.83 | Facility | None | $645.65 | $1,230.27 | $2,398.83 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $602.56 Typical High $1,584.89 | Professional | None | $426.58 | $602.56 | $1,584.89 |
BCBS Alabama Setting Facility Modifier None Typical Low $2,630.27 Median $2,691.53 Typical High $2,691.53 | Facility | None | $2,630.27 | $2,691.53 | $2,691.53 |
BCBS Alabama Setting Professional Modifier None Typical Low $602.56 Median $831.76 Typical High $933.25 | Professional | None | $602.56 | $831.76 | $933.25 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $630.96 Typical High $1,122.02 | Professional | None | $245.47 | $630.96 | $1,122.02 |
United Setting Facility Modifier None Typical Low $1,096.48 Median $3,467.37 Typical High $5,370.32 | Facility | None | $1,096.48 | $3,467.37 | $5,370.32 |
United Setting Professional Modifier None Typical Low $190.55 Median $691.83 Typical High $1,318.26 | Professional | None | $190.55 | $691.83 | $1,318.26 |
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 $213.80 Median $302.00 Typical High $794.33 | Professional | 52 · Reduced service | $213.80 | $302.00 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $120.23 Typical High $316.23 | Professional | 53 · Discontinued | $85.11 | $120.23 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $446.68 Typical High $1,174.90 | Professional | 54 · Surgery only | $316.23 | $446.68 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $89.13 Typical High $234.42 | Professional | 55 · Aftercare only | $63.10 | $89.13 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $60.26 Typical High $158.49 | Professional | 56 · Pre-op care only | $42.66 | $60.26 | $158.49 |
Where Alabama sits
The same service costs 5.4 times more in Wisconsin than in Maryland. 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· 21st of 51
$832
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.