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 $645.65 Median $1,230.27 Typical High $2,398.83 | Facility | None | $645.65 | $1,230.27 | $2,398.83 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $302.00 Typical High $338.84 | Professional | None | $263.03 | $302.00 | $338.84 |
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 $269.15 Median $363.08 Typical High $467.74 | Professional | None | $269.15 | $363.08 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $194.98 Typical High $446.68 | Facility | None | $50.12 | $194.98 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $269.15 Typical High $331.13 | Professional | None | $263.03 | $269.15 | $331.13 |
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 $229.09 Median $295.12 Typical High $436.52 | Professional | None | $229.09 | $295.12 | $436.52 |
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 $131.83 Median $151.36 Typical High $169.82 | Professional | 52 · Reduced service | $131.83 | $151.36 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $60.26 Typical High $67.61 | Professional | 53 · Discontinued | $52.48 | $60.26 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $223.87 Typical High $251.19 | Professional | 54 · Surgery only | $194.98 | $223.87 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $44.67 Typical High $51.29 | Professional | 55 · Aftercare only | $38.90 | $44.67 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $30.20 Typical High $33.88 | Professional | 56 · Pre-op care only | $26.30 | $30.20 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $208.93 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $181.97 | $208.93 | $234.42 |
Where Alabama sits
The same service costs 4.0 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· 49th of 51
$282
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.