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 $1,122.02 Typical High $1,905.46 | Facility | None | $645.65 | $1,122.02 | $1,905.46 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $741.31 | Professional | None | $588.84 | $588.84 | $741.31 |
BCBS Alabama Setting Facility Modifier None Typical Low $5,754.40 Median $5,754.40 Typical High $5,754.40 | Facility | None | $5,754.40 | $5,754.40 | $5,754.40 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $1,412.54 Typical High $1,737.80 | Facility | None | $489.78 | $1,412.54 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $562.34 Typical High $691.83 | Professional | None | $467.74 | $562.34 | $691.83 |
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 $316.23 Median $426.58 Typical High $691.83 | Professional | None | $316.23 | $426.58 | $691.83 |
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 $295.12 Median $295.12 Typical High $371.54 | Professional | 52 · Reduced service | $295.12 | $295.12 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $117.49 Typical High $147.91 | Professional | 53 · Discontinued | $117.49 | $117.49 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $446.68 Typical High $562.34 | Professional | 54 · Surgery only | $446.68 | $446.68 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $89.13 Typical High $112.20 | Professional | 55 · Aftercare only | $89.13 | $89.13 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $58.88 Typical High $74.13 | Professional | 56 · Pre-op care only | $58.88 | $58.88 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $416.87 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $416.87 | $416.87 | $524.81 |
BCBS Alabama Setting Professional Modifier 32 · Mandated service Typical Low $512.86 Median $707.95 Typical High $758.58 | Professional | 32 · Mandated service | $512.86 | $707.95 | $758.58 |
Where Alabama sits
The same service costs 6.0 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· 22nd of 51
$589
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.