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 Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | None | $75.86 | $75.86 | $75.86 |
BCBS Alabama Setting Facility Modifier None Typical Low $38.90 Median $39.81 Typical High $39.81 | Facility | None | $38.90 | $39.81 | $39.81 |
Cigna Setting Facility Modifier None Typical Low $81.28 Median $83.18 Typical High $104.71 | Facility | None | $81.28 | $83.18 | $104.71 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $97.72 | Professional | None | $81.28 | $81.28 | $97.72 |
United Setting Facility Modifier None Typical Low $74.13 Median $77.62 Typical High $77.62 | Facility | None | $74.13 | $77.62 | $77.62 |
United Setting Professional Modifier None Typical Low $72.44 Median $81.28 Typical High $87.10 | Professional | None | $72.44 | $81.28 | $87.10 |
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 $37.15 Median $37.15 Typical High $37.15 | Professional | 52 · Reduced service | $37.15 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | 53 · Discontinued | $15.14 | $15.14 | $15.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $11.22 Typical High $11.22 | Professional | 55 · Aftercare only | $11.22 | $11.22 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $7.59 Typical High $7.59 | Professional | 56 · Pre-op care only | $7.59 | $7.59 | $7.59 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 52 · Reduced service + 55 · Aftercare only Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 52 · Reduced service + 55 · Aftercare only | $72.44 | $72.44 | $72.44 |
Where Alabama sits
The same service costs 3.0 times more in Arizona than in Alabama. 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· 51st of 51
$39.81
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.