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 $645.65 Median $1,230.27 Typical High $2,398.83 | Facility | None | $645.65 | $1,230.27 | $2,398.83 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | None | $275.42 | $275.42 | $275.42 |
BCBS Alabama Setting Facility Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Facility | None | $1,995.26 | $1,995.26 | $1,995.26 |
BCBS Alabama Setting Professional Modifier None Typical Low $128.82 Median $177.83 Typical High $245.47 | Professional | None | $128.82 | $177.83 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $537.03 Typical High $977.24 | Facility | None | $478.63 | $537.03 | $977.24 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $208.93 Typical High $263.03 | Professional | None | $177.83 | $208.93 | $263.03 |
United Setting Facility Modifier None Typical Low $100.00 Median $323.59 Typical High $1,380.38 | Facility | None | $100.00 | $323.59 | $1,380.38 |
United Setting Professional Modifier None Typical Low $144.54 Median $177.83 Typical High $309.03 | Professional | None | $144.54 | $177.83 | $309.03 |
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 $138.04 Median $138.04 Typical High $138.04 | Professional | 52 · Reduced service | $138.04 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | 53 · Discontinued | $54.95 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | 54 · Surgery only | $208.93 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | 55 · Aftercare only | $41.69 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $27.54 Typical High $27.54 | Professional | 56 · Pre-op care only | $27.54 | $27.54 | $27.54 |
Where Alabama sits
The same service costs 4.5 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· 37th of 51
$209
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.