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 $562.34 Median $954.99 Typical High $2,398.83 | Facility | None | $562.34 | $954.99 | $2,398.83 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $147.91 Typical High $257.04 | Professional | None | $117.49 | $147.91 | $257.04 |
Ambetter Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $165.96 | Professional | None | $141.25 | $141.25 | $165.96 |
BCBS Alabama Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Facility | None | $95.50 | $95.50 | $95.50 |
BCBS Alabama Setting Professional Modifier None Typical Low $181.97 Median $218.78 Typical High $251.19 | Professional | None | $181.97 | $218.78 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $102.33 Typical High $512.86 | Facility | None | $50.12 | $102.33 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $147.91 Typical High $229.09 | Professional | None | $102.33 | $147.91 | $229.09 |
United Setting Facility Modifier None Typical Low $100.00 Median $371.54 Typical High $1,380.38 | Facility | None | $100.00 | $371.54 | $1,380.38 |
United Setting Professional Modifier None Typical Low $74.13 Median $120.23 Typical High $165.96 | Professional | None | $74.13 | $120.23 | $165.96 |
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 $74.13 Median $74.13 Typical High $128.82 | Professional | 52 · Reduced service | $74.13 | $74.13 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $30.20 Typical High $51.29 | Professional | 53 · Discontinued | $30.20 | $30.20 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $112.20 Typical High $190.55 | Professional | 54 · Surgery only | $112.20 | $112.20 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $22.39 Typical High $38.02 | Professional | 55 · Aftercare only | $22.39 | $22.39 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $14.79 Typical High $25.70 | Professional | 56 · Pre-op care only | $14.79 | $14.79 | $25.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $104.71 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $104.71 | $104.71 | $177.83 |
Where Alabama sits
The same service costs 4.5 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· 21st of 51
$158
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.