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 $141.25 Median $141.25 Typical High $302.00 | Professional | None | $141.25 | $141.25 | $302.00 |
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 32 · Mandated service Typical Low $109.65 Median $151.36 Typical High $234.42 | Professional | 32 · Mandated service | $109.65 | $151.36 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $112.20 Median $138.04 Typical High $501.19 | Facility | None | $112.20 | $138.04 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $112.20 Typical High $173.78 | Professional | None | $66.07 | $112.20 | $173.78 |
United Setting Facility Modifier None Typical Low $100.00 Median $363.08 Typical High $1,380.38 | Facility | None | $100.00 | $363.08 | $1,380.38 |
United Setting Professional Modifier None Typical Low $61.66 Median $109.65 Typical High $162.18 | Professional | None | $61.66 | $109.65 | $162.18 |
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 $70.79 Median $81.28 Typical High $151.36 | Professional | 52 · Reduced service | $70.79 | $81.28 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $32.36 Typical High $60.26 | Professional | 53 · Discontinued | $28.18 | $32.36 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $120.23 Typical High $229.09 | Professional | 54 · Surgery only | $104.71 | $120.23 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $23.99 Typical High $45.71 | Professional | 55 · Aftercare only | $20.89 | $23.99 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $16.22 Typical High $30.20 | Professional | 56 · Pre-op care only | $14.13 | $16.22 | $30.20 |
Where Alabama sits
The same service costs 3.6 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· 39th of 51
$141
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.