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 $323.59 Median $380.19 Typical High $676.08 | Professional | None | $323.59 | $380.19 | $676.08 |
BCBS Alabama Setting Facility Modifier None Typical Low $549.54 Median $562.34 Typical High $562.34 | Facility | None | $549.54 | $562.34 | $562.34 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 41 Typical Low $169.82 Median $208.93 Typical High $239.88 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 41 | $169.82 | $208.93 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $295.12 Median $363.08 Typical High $630.96 | Facility | None | $295.12 | $363.08 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $331.13 Typical High $489.78 | Professional | None | $177.83 | $331.13 | $489.78 |
United Setting Facility Modifier None Typical Low $309.03 Median $616.60 Typical High $2,511.89 | Facility | None | $309.03 | $616.60 | $2,511.89 |
United Setting Professional Modifier None Typical Low $141.25 Median $309.03 Typical High $501.19 | Professional | None | $141.25 | $309.03 | $501.19 |
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 $162.18 Median $190.55 Typical High $338.84 | Professional | 52 · Reduced service | $162.18 | $190.55 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $75.86 Typical High $138.04 | Professional | 53 · Discontinued | $64.57 | $75.86 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $288.40 Typical High $512.86 | Professional | 54 · Surgery only | $239.88 | $288.40 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $57.54 Typical High $102.33 | Professional | 55 · Aftercare only | $47.86 | $57.54 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $38.02 Typical High $67.61 | Professional | 56 · Pre-op care only | $32.36 | $38.02 | $67.61 |
Where Alabama sits
The same service costs 2.8 times more in Wisconsin 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· 30th of 51
$389
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.