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 $204.17 Median $309.03 Typical High $354.81 | Professional | None | $204.17 | $309.03 | $354.81 |
BCBS Alabama Setting Facility Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Facility | None | $239.88 | $239.88 | $239.88 |
BCBS Alabama Setting Professional Modifier None Typical Low $234.42 Median $316.23 Typical High $549.54 | Professional | None | $234.42 | $316.23 | $549.54 |
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 $223.87 Median $338.84 Typical High $758.58 | Professional | None | $223.87 | $338.84 | $758.58 |
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 $190.55 Median $323.59 Typical High $457.09 | Professional | None | $190.55 | $323.59 | $457.09 |
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 $102.33 Median $154.88 Typical High $177.83 | Professional | 52 · Reduced service | $102.33 | $154.88 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $63.10 Typical High $70.79 | Professional | 53 · Discontinued | $40.74 | $63.10 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $234.42 Typical High $269.15 | Professional | 54 · Surgery only | $154.88 | $234.42 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $46.77 Typical High $53.70 | Professional | 55 · Aftercare only | $30.90 | $46.77 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $30.90 Typical High $35.48 | Professional | 56 · Pre-op care only | $20.42 | $30.90 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $218.78 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $144.54 | $218.78 | $251.19 |
Where Alabama sits
The same service costs 4.6 times more in Alaska than in Texas. 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· 39th of 51
$316
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.