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 $776.25 Median $1,258.93 Typical High $2,630.27 | Facility | None | $776.25 | $1,258.93 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $134.90 Typical High $186.21 | Professional | None | $125.89 | $134.90 | $186.21 |
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 $83.18 Median $114.82 Typical High $173.78 | Professional | 32 · Mandated service | $83.18 | $114.82 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $77.62 Typical High $446.68 | Facility | None | $50.12 | $77.62 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $114.82 Typical High $186.21 | Professional | None | $75.86 | $114.82 | $186.21 |
United Setting Facility Modifier None Typical Low $316.23 Median $645.65 Typical High $2,511.89 | Facility | None | $316.23 | $645.65 | $2,511.89 |
United Setting Professional Modifier None Typical Low $72.44 Median $107.15 Typical High $147.91 | Professional | None | $72.44 | $107.15 | $147.91 |
6 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 $66.07 Median $66.07 Typical High $93.33 | Professional | 52 · Reduced service | $66.07 | $66.07 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $26.92 Typical High $37.15 | Professional | 53 · Discontinued | $26.92 | $26.92 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $100.00 Typical High $138.04 | Professional | 54 · Surgery only | $100.00 | $100.00 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $19.95 Typical High $28.18 | Professional | 55 · Aftercare only | $19.95 | $19.95 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $13.49 Typical High $18.62 | Professional | 56 · Pre-op care only | $13.49 | $13.49 | $18.62 |
BCBS Alabama Setting Facility Modifier 50 · Both sides Typical Low $158.49 Median $158.49 Typical High $158.49 | Facility | 50 · Both sides | $158.49 | $158.49 | $158.49 |
Where Alabama sits
The same service costs 3.2 times more in Wisconsin than in Texas. 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· 45th of 51
$120
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.