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 $776.25 Median $1,258.93 Typical High $2,630.27 | Facility | None | $776.25 | $1,258.93 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $125.89 Typical High $181.97 | Professional | None | $81.28 | $125.89 | $181.97 |
BCBS Alabama Setting Facility Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Facility | None | $162.18 | $162.18 | $162.18 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $138.04 Typical High $213.80 | Professional | None | $77.62 | $138.04 | $213.80 |
United Setting Facility Modifier None Typical Low $43.65 Median $53.70 Typical High $53.70 | Facility | None | $43.65 | $53.70 | $53.70 |
United Setting Professional Modifier None Typical Low $58.88 Median $123.03 Typical High $181.97 | Professional | None | $58.88 | $123.03 | $181.97 |
6 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 $40.74 Median $63.10 Typical High $89.13 | Professional | 52 · Reduced service | $40.74 | $63.10 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $25.12 Typical High $36.31 | Professional | 53 · Discontinued | $16.22 | $25.12 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $95.50 Typical High $134.90 | Professional | 54 · Surgery only | $61.66 | $95.50 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $19.05 Typical High $26.92 | Professional | 55 · Aftercare only | $12.30 | $19.05 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $12.59 Typical High $18.20 | Professional | 56 · Pre-op care only | $8.13 | $12.59 | $18.20 |
BCBS Alabama Setting Professional Modifier 12 + 32 · Mandated service Typical Low $102.33 Median $141.25 Typical High $199.53 | Professional | 12 + 32 · Mandated service | $102.33 | $141.25 | $199.53 |
Where Alabama sits
The same service costs 3.5 times more in Alaska than in Kentucky. 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· 32nd of 51
$138
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.