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 $21.88 Median $831.76 Typical High $1,862.09 | Facility | None | $21.88 | $831.76 | $1,862.09 |
Aetna Setting Professional Modifier None Typical Low $20.42 Median $21.88 Typical High $22.39 | Professional | None | $20.42 | $21.88 | $22.39 |
BCBS Alabama Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Facility | None | $64.57 | $64.57 | $64.57 |
BCBS Alabama Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | None | $43.65 | $43.65 | $43.65 |
Cigna Setting Facility Modifier None Typical Low $33.11 Median $61.66 Typical High $69.18 | Facility | None | $33.11 | $61.66 | $69.18 |
Cigna Setting Professional Modifier None Typical Low $23.44 Median $23.44 Typical High $28.18 | Professional | None | $23.44 | $23.44 | $28.18 |
United Setting Facility Modifier None Typical Low $54.95 Median $56.23 Typical High $75.86 | Facility | None | $54.95 | $56.23 | $75.86 |
United Setting Professional Modifier None Typical Low $14.79 Median $18.62 Typical High $27.54 | Professional | None | $14.79 | $18.62 | $27.54 |
4 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 $10.72 Median $10.72 Typical High $10.72 | Professional | 52 · Reduced service | $10.72 | $10.72 | $10.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.37 Median $4.37 Typical High $4.37 | Professional | 53 · Discontinued | $4.37 | $4.37 | $4.37 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.24 Median $3.24 Typical High $3.24 | Professional | 55 · Aftercare only | $3.24 | $3.24 | $3.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.19 Median $2.19 Typical High $2.19 | Professional | 56 · Pre-op care only | $2.19 | $2.19 | $2.19 |
Where Alabama sits
The same service costs 40.7 times more in Tennessee 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· 5th of 51
$64.57
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.