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 $489.78 Median $933.25 Typical High $1,862.09 | Facility | None | $489.78 | $933.25 | $1,862.09 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $138.04 | Professional | None | $89.13 | $89.13 | $138.04 |
BCBS Alabama Setting Facility Modifier None Typical Low $660.69 Median $676.08 Typical High $676.08 | Facility | None | $660.69 | $676.08 | $676.08 |
BCBS Alabama Setting Professional Modifier 32 · Mandated service Typical Low $70.79 Median $97.72 Typical High $151.36 | Professional | 32 · Mandated service | $70.79 | $97.72 | $151.36 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $69.18 Typical High $501.19 | Facility | None | $56.23 | $69.18 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $93.33 Typical High $141.25 | Professional | None | $74.13 | $93.33 | $141.25 |
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 $57.54 Median $85.11 Typical High $117.49 | Professional | None | $57.54 | $85.11 | $117.49 |
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 $44.67 Median $44.67 Typical High $69.18 | Professional | 52 · Reduced service | $44.67 | $44.67 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $17.78 Typical High $27.54 | Professional | 53 · Discontinued | $17.78 | $17.78 | $27.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $66.07 Typical High $102.33 | Professional | 54 · Surgery only | $66.07 | $66.07 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $13.49 Typical High $20.42 | Professional | 55 · Aftercare only | $13.49 | $13.49 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $8.91 Typical High $13.80 | Professional | 56 · Pre-op care only | $8.91 | $8.91 | $13.80 |
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· 36th of 51
$102
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.