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 $426.58 Median $1,096.48 Typical High $2,089.30 | Facility | None | $426.58 | $1,096.48 | $2,089.30 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $426.58 Typical High $426.58 | Professional | None | $389.05 | $426.58 | $426.58 |
BCBS Alabama Setting Facility Modifier None Typical Low $3,311.31 Median $3,311.31 Typical High $3,311.31 | Facility | None | $3,311.31 | $3,311.31 | $3,311.31 |
BCBS Alabama Setting Professional Modifier None Typical Low $416.87 Median $512.86 Typical High $691.83 | Professional | None | $416.87 | $512.86 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $2,187.76 Typical High $2,691.53 | Facility | None | $549.54 | $2,187.76 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $426.58 Typical High $707.95 | Professional | None | $331.13 | $426.58 | $707.95 |
United Setting Facility Modifier None Typical Low $1,096.48 Median $2,454.71 Typical High $5,370.32 | Facility | None | $1,096.48 | $2,454.71 | $5,370.32 |
United Setting Professional Modifier None Typical Low $245.47 Median $346.74 Typical High $501.19 | Professional | None | $245.47 | $346.74 | $501.19 |
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 $208.93 Median $208.93 Typical High $208.93 | Professional | 52 · Reduced service | $208.93 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | 53 · Discontinued | $85.11 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | 54 · Surgery only | $316.23 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | 55 · Aftercare only | $63.10 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | 56 · Pre-op care only | $42.66 | $42.66 | $42.66 |
Where Alabama sits
The same service costs 10.0 times more in Oklahoma 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· 25th of 51
$537
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.