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 $426.58 Median $426.58 Typical High $588.84 | Professional | None | $426.58 | $426.58 | $588.84 |
BCBS Alabama Setting Facility Modifier None Typical Low $4,265.80 Median $4,265.80 Typical High $4,265.80 | Facility | None | $4,265.80 | $4,265.80 | $4,265.80 |
BCBS Alabama Setting Professional Modifier None Typical Low $346.74 Median $467.74 Typical High $512.86 | Professional | None | $346.74 | $467.74 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $251.19 Median $309.03 Typical High $933.25 | Facility | None | $251.19 | $309.03 | $933.25 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $407.38 Typical High $467.74 | Professional | None | $346.74 | $407.38 | $467.74 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,737.80 Typical High $4,168.69 | Facility | None | $758.58 | $1,737.80 | $4,168.69 |
United Setting Professional Modifier None Typical Low $223.87 Median $323.59 Typical High $537.03 | Professional | None | $223.87 | $323.59 | $537.03 |
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 $213.80 Median $213.80 Typical High $295.12 | Professional | 52 · Reduced service | $213.80 | $213.80 | $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 $446.68 | Professional | 54 · Surgery only | $316.23 | $316.23 | $446.68 |
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 |
Where Alabama sits
The same service costs 5.2 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· 17th of 51
$468
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.