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 $891.25 Median $1,348.96 Typical High $2,398.83 | Facility | None | $891.25 | $1,348.96 | $2,398.83 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $186.21 Typical High $186.21 | Professional | None | $173.78 | $186.21 | $186.21 |
BCBS Alabama Setting Facility Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $2,754.23 | Facility | None | $2,754.23 | $2,754.23 | $2,754.23 |
BCBS Alabama Setting Professional Modifier None Typical Low $125.89 Median $173.78 Typical High $223.87 | Professional | None | $125.89 | $173.78 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $1,737.80 Typical High $2,041.74 | Facility | None | $741.31 | $1,737.80 | $2,041.74 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $138.04 Typical High $199.53 | Professional | None | $128.82 | $138.04 | $199.53 |
United Setting Facility Modifier None Typical Low $1,096.48 Median $2,454.71 Typical High $5,248.07 | Facility | None | $1,096.48 | $2,454.71 | $5,248.07 |
United Setting Professional Modifier None Typical Low $104.71 Median $131.83 Typical High $194.98 | Professional | None | $104.71 | $131.83 | $194.98 |
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 $93.33 Median $93.33 Typical High $93.33 | Professional | 52 · Reduced service | $93.33 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | 53 · Discontinued | $37.15 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | 54 · Surgery only | $141.25 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | 55 · Aftercare only | $28.18 | $28.18 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $18.62 Typical High $18.62 | Professional | 56 · Pre-op care only | $18.62 | $18.62 | $18.62 |
Where Alabama sits
The same service costs 10.7 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· 31st of 51
$186
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.