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 $162.18 Median $208.93 Typical High $229.09 | Professional | None | $162.18 | $208.93 | $229.09 |
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 $181.97 Median $251.19 Typical High $323.59 | Professional | None | $181.97 | $251.19 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $173.78 Typical High $501.19 | Facility | None | $138.04 | $173.78 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $181.97 Typical High $223.87 | Professional | None | $165.96 | $181.97 | $223.87 |
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 $141.25 Median $194.98 Typical High $302.00 | Professional | None | $141.25 | $194.98 | $302.00 |
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 $81.28 Median $100.00 Typical High $114.82 | Professional | 52 · Reduced service | $81.28 | $100.00 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $39.81 Typical High $45.71 | Professional | 53 · Discontinued | $32.36 | $39.81 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $151.36 Typical High $173.78 | Professional | 54 · Surgery only | $120.23 | $151.36 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $30.20 Typical High $34.67 | Professional | 55 · Aftercare only | $23.99 | $30.20 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $19.95 Typical High $22.91 | Professional | 56 · Pre-op care only | $16.22 | $19.95 | $22.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $141.25 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $112.20 | $141.25 | $162.18 |
Where Alabama sits
The same service costs 3.5 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· 35th of 51
$229
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.