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 $21.38 Median $21.38 Typical High $21.38 | Professional | None | $21.38 | $21.38 | $21.38 |
BCBS Alabama Setting Facility Modifier None Typical Low $758.58 Median $776.25 Typical High $776.25 | Facility | None | $758.58 | $776.25 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $21.38 Median $21.88 Typical High $27.54 | Facility | None | $21.38 | $21.88 | $27.54 |
Cigna Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $24.55 | Professional | None | $21.38 | $21.38 | $24.55 |
United Setting Facility Modifier None Typical Low $20.42 Median $20.42 Typical High $20.42 | Facility | None | $20.42 | $20.42 | $20.42 |
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 $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 $4.27 Median $4.27 Typical High $4.27 | Professional | 53 · Discontinued | $4.27 | $4.27 | $4.27 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $16.22 Median $16.22 Typical High $16.22 | Professional | 54 · Surgery only | $16.22 | $16.22 | $16.22 |
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 $2.14 Median $2.14 Typical High $2.14 | Professional | 56 · Pre-op care only | $2.14 | $2.14 | $2.14 |
Where Alabama sits
The same service costs 39.8 times more in Alabama than in Georgia. 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· 1st of 51
$759
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.