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 $67.61 Median $83.18 Typical High $102.33 | Professional | None | $67.61 | $83.18 | $102.33 |
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 $74.13 Median $102.33 Typical High $131.83 | Professional | None | $74.13 | $102.33 | $131.83 |
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 $64.57 Median $70.79 Typical High $97.72 | Professional | None | $64.57 | $70.79 | $97.72 |
United Setting Facility Modifier None Typical Low $100.00 Median $363.08 Typical High $1,380.38 | Facility | None | $100.00 | $363.08 | $1,380.38 |
United Setting Professional Modifier None Typical Low $57.54 Median $77.62 Typical High $117.49 | Professional | None | $57.54 | $77.62 | $117.49 |
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 $33.88 Median $38.90 Typical High $46.77 | Professional | 52 · Reduced service | $33.88 | $38.90 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $15.49 Typical High $18.62 | Professional | 53 · Discontinued | $13.49 | $15.49 | $18.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $57.54 Typical High $70.79 | Professional | 54 · Surgery only | $51.29 | $57.54 | $70.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $11.75 Typical High $14.13 | Professional | 55 · Aftercare only | $10.23 | $11.75 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $7.76 Typical High $9.33 | Professional | 56 · Pre-op care only | $6.76 | $7.76 | $9.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $47.86 Median $53.70 Typical High $66.07 | Professional | 78 · Unplanned return to OR | $47.86 | $53.70 | $66.07 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | 59 · Distinct service | $100.00 | $100.00 | $100.00 |
Where Alabama sits
The same service costs 3.8 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· 37th of 51
$93.33
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.