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 $125.89 Median $125.89 Typical High $169.82 | Professional | None | $125.89 | $125.89 | $169.82 |
BCBS Alabama Setting Facility Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Facility | None | $104.71 | $104.71 | $104.71 |
BCBS Alabama Setting Professional Modifier 32 · Mandated service Typical Low $61.66 Median $85.11 Typical High $125.89 | Professional | 32 · Mandated service | $61.66 | $85.11 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $44.67 Median $54.95 Typical High $501.19 | Facility | None | $44.67 | $54.95 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $87.10 Typical High $134.90 | Professional | None | $67.61 | $87.10 | $134.90 |
United Setting Facility Modifier None Typical Low $100.00 Median $323.59 Typical High $1,380.38 | Facility | None | $100.00 | $323.59 | $1,380.38 |
United Setting Professional Modifier None Typical Low $54.95 Median $79.43 Typical High $109.65 | Professional | None | $54.95 | $79.43 | $109.65 |
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 $63.10 Median $63.10 Typical High $85.11 | Professional | 52 · Reduced service | $63.10 | $63.10 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $25.12 Typical High $34.67 | Professional | 53 · Discontinued | $25.12 | $25.12 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $93.33 Typical High $128.82 | Professional | 54 · Surgery only | $93.33 | $93.33 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $18.62 Typical High $25.70 | Professional | 55 · Aftercare only | $18.62 | $18.62 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $12.59 Typical High $16.98 | Professional | 56 · Pre-op care only | $12.59 | $12.59 | $16.98 |
Where Alabama sits
The same service costs 3.5 times more in Wisconsin than in Florida. 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
$105
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.