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 $83.18 Median $120.23 Typical High $144.54 | Professional | None | $83.18 | $120.23 | $144.54 |
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 $91.20 Median $123.03 Typical High $177.83 | Professional | None | $91.20 | $123.03 | $177.83 |
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 $83.18 Median $104.71 Typical High $128.82 | Professional | None | $83.18 | $104.71 | $128.82 |
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 $70.79 Median $104.71 Typical High $154.88 | Professional | None | $70.79 | $104.71 | $154.88 |
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 $41.69 Median $54.95 Typical High $66.07 | Professional | 52 · Reduced service | $41.69 | $54.95 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $21.88 Typical High $26.30 | Professional | 53 · Discontinued | $16.60 | $21.88 | $26.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $81.28 Typical High $97.72 | Professional | 54 · Surgery only | $63.10 | $81.28 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $16.22 Typical High $19.95 | Professional | 55 · Aftercare only | $12.59 | $16.22 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $10.96 Typical High $13.18 | Professional | 56 · Pre-op care only | $8.32 | $10.96 | $13.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $58.88 Median $75.86 Typical High $91.20 | Professional | 78 · Unplanned return to OR | $58.88 | $75.86 | $91.20 |
Where Alabama sits
The same service costs 3.5 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· 36th of 51
$129
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.