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 $169.82 Median $169.82 Typical High $169.82 | Professional | None | $169.82 | $169.82 | $169.82 |
BCBS Alabama Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
BCBS Alabama Setting Professional Modifier None Typical Low $104.71 Median $141.25 Typical High $186.21 | Professional | None | $104.71 | $141.25 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $407.38 Typical High $549.54 | Facility | None | $338.84 | $407.38 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $147.91 Typical High $181.97 | Professional | None | $125.89 | $147.91 | $181.97 |
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 $87.10 Median $107.15 Typical High $177.83 | Professional | None | $87.10 | $107.15 | $177.83 |
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 $85.11 Median $85.11 Typical High $85.11 | Professional | 52 · Reduced service | $85.11 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | 53 · Discontinued | $34.67 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | 54 · Surgery only | $128.82 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | 55 · Aftercare only | $25.70 | $25.70 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | 56 · Pre-op care only | $17.38 | $17.38 | $17.38 |
Where Alabama sits
The same service costs 4.4 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· 31st of 51
$170
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.