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 $154.88 Median $165.96 Typical High $234.42 | Professional | None | $154.88 | $165.96 | $234.42 |
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 $147.91 Median $204.17 Typical High $251.19 | Professional | 32 · Mandated service | $147.91 | $204.17 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $91.20 Median $114.82 Typical High $501.19 | Facility | None | $91.20 | $114.82 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $169.82 Typical High $213.80 | Professional | None | $134.90 | $169.82 | $213.80 |
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 $104.71 Median $158.49 Typical High $204.17 | Professional | None | $104.71 | $158.49 | $204.17 |
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 $83.18 Median $83.18 Typical High $117.49 | Professional | 52 · Reduced service | $83.18 | $83.18 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $33.11 Typical High $47.86 | Professional | 53 · Discontinued | $33.11 | $33.11 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $123.03 Typical High $177.83 | Professional | 54 · Surgery only | $123.03 | $123.03 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $24.55 Typical High $35.48 | Professional | 55 · Aftercare only | $24.55 | $24.55 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $16.60 Typical High $23.44 | Professional | 56 · Pre-op care only | $16.60 | $16.60 | $23.44 |
Where Alabama sits
The same service costs 3.7 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· 29th of 51
$195
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.