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 $16.22 Median $16.22 Typical High $21.88 | Facility | None | $16.22 | $16.22 | $21.88 |
Aetna Setting Professional Modifier None Typical Low $16.22 Median $16.22 Typical High $19.50 | Professional | None | $16.22 | $16.22 | $19.50 |
BCBS Alabama Setting Facility Modifier None Typical Low $602.56 Median $602.56 Typical High $602.56 | Facility | None | $602.56 | $602.56 | $602.56 |
BCBS Alabama Setting Professional Modifier None Typical Low $16.60 Median $19.05 Typical High $23.44 | Professional | None | $16.60 | $19.05 | $23.44 |
Cigna Setting Facility Modifier None Typical Low $5.75 Median $7.08 Typical High $501.19 | Facility | None | $5.75 | $7.08 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $12.88 Median $16.60 Typical High $23.99 | Professional | None | $12.88 | $16.60 | $23.99 |
United Setting Facility Modifier None Typical Low $100.00 Median $309.03 Typical High $1,380.38 | Facility | None | $100.00 | $309.03 | $1,380.38 |
United Setting Professional Modifier None Typical Low $10.72 Median $15.14 Typical High $25.70 | Professional | None | $10.72 | $15.14 | $25.70 |
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 $8.13 Median $8.13 Typical High $9.77 | Professional | 52 · Reduced service | $8.13 | $8.13 | $9.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.24 Median $3.24 Typical High $3.98 | Professional | 53 · Discontinued | $3.24 | $3.24 | $3.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $12.30 Median $12.30 Typical High $14.79 | Professional | 54 · Surgery only | $12.30 | $12.30 | $14.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.45 Median $2.45 Typical High $2.95 | Professional | 55 · Aftercare only | $2.45 | $2.45 | $2.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.62 Median $1.62 Typical High $1.95 | Professional | 56 · Pre-op care only | $1.62 | $1.62 | $1.95 |
Where Alabama sits
The same service costs 3.5 times more in Alaska than in New York. 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· 34th of 51
$19.05
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.