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 $933.25 Typical High $1,862.09 | Facility | None | $562.34 | $933.25 | $1,862.09 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $426.58 Typical High $588.84 | Professional | None | $316.23 | $426.58 | $588.84 |
Ambetter Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $346.74 | Professional | None | $107.15 | $107.15 | $346.74 |
BCBS Alabama Setting Facility Modifier None Typical Low $2,511.89 Median $2,570.40 Typical High $2,570.40 | Facility | None | $2,511.89 | $2,570.40 | $2,570.40 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $288.40 Typical High $478.63 | Facility | None | $50.12 | $288.40 | $478.63 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $389.05 Typical High $407.38 | Professional | None | $302.00 | $389.05 | $407.38 |
United Setting Facility Modifier None Typical Low $316.23 Median $645.65 Typical High $2,511.89 | Facility | None | $316.23 | $645.65 | $2,511.89 |
United Setting Professional Modifier None Typical Low $208.93 Median $302.00 Typical High $501.19 | Professional | None | $208.93 | $302.00 | $501.19 |
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 $208.93 Median $208.93 Typical High $295.12 | Professional | 52 · Reduced service | $208.93 | $208.93 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $85.11 Typical High $117.49 | Professional | 53 · Discontinued | $85.11 | $85.11 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $316.23 Typical High $436.52 | Professional | 54 · Surgery only | $316.23 | $316.23 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $63.10 Typical High $89.13 | Professional | 55 · Aftercare only | $63.10 | $63.10 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $42.66 Typical High $58.88 | Professional | 56 · Pre-op care only | $42.66 | $42.66 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $295.12 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $295.12 | $295.12 | $416.87 |
BCBS Alabama Setting Professional Modifier 32 · Mandated service Typical Low $295.12 Median $407.38 Typical High $512.86 | Professional | 32 · Mandated service | $295.12 | $407.38 | $512.86 |
Where Alabama sits
The same service costs 4.5 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· 24th of 51
$398
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.