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 $263.03 Median $295.12 Typical High $323.59 | Professional | None | $263.03 | $295.12 | $323.59 |
BCBS Alabama Setting Facility Modifier None Typical Low $1,584.89 Median $1,621.81 Typical High $1,621.81 | Facility | None | $1,584.89 | $1,621.81 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $245.47 Typical High $501.19 | Facility | None | $199.53 | $245.47 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $257.04 Typical High $316.23 | Professional | None | $239.88 | $257.04 | $316.23 |
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 $223.87 Median $281.84 Typical High $436.52 | Professional | None | $223.87 | $281.84 | $436.52 |
7 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 $131.83 Median $147.91 Typical High $162.18 | Professional | 52 · Reduced service | $131.83 | $147.91 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $58.88 Typical High $64.57 | Professional | 53 · Discontinued | $52.48 | $58.88 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $218.78 Typical High $245.47 | Professional | 54 · Surgery only | $199.53 | $218.78 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $43.65 Typical High $48.98 | Professional | 55 · Aftercare only | $39.81 | $43.65 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $29.51 Typical High $32.36 | Professional | 56 · Pre-op care only | $26.30 | $29.51 | $32.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $204.17 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $186.21 | $204.17 | $229.09 |
BCBS Alabama Setting Professional Modifier 32 · Mandated service Typical Low $234.42 Median $323.59 Typical High $446.68 | Professional | 32 · Mandated service | $234.42 | $323.59 | $446.68 |
Where Alabama sits
The same service costs 4.7 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· 44th 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.