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 $933.25 Median $933.25 Typical High $1,122.02 | Professional | None | $933.25 | $933.25 | $1,122.02 |
Ambetter Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | None | $346.74 | $346.74 | $346.74 |
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 $660.69 Typical High $933.25 | Facility | None | $489.78 | $660.69 | $933.25 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $812.83 Typical High $870.96 | Professional | None | $645.65 | $812.83 | $870.96 |
United Setting Facility Modifier None Typical Low $467.74 Median $1,000.00 Typical High $3,162.28 | Facility | None | $467.74 | $1,000.00 | $3,162.28 |
United Setting Professional Modifier None Typical Low $457.09 Median $575.44 Typical High $977.24 | Professional | None | $457.09 | $575.44 | $977.24 |
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 $467.74 Median $467.74 Typical High $549.54 | Professional | 52 · Reduced service | $467.74 | $467.74 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $186.21 Typical High $223.87 | Professional | 53 · Discontinued | $186.21 | $186.21 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $691.83 Typical High $831.76 | Professional | 54 · Surgery only | $691.83 | $691.83 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $138.04 Typical High $165.96 | Professional | 55 · Aftercare only | $138.04 | $138.04 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $93.33 Typical High $112.20 | Professional | 56 · Pre-op care only | $93.33 | $93.33 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $645.65 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $645.65 | $645.65 | $776.25 |
BCBS Alabama Setting Professional Modifier 32 · Mandated service Typical Low $588.84 Median $812.83 Typical High $1,000.00 | Professional | 32 · Mandated service | $588.84 | $812.83 | $1,000.00 |
Where Alabama sits
The same service costs 5.6 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· 21st of 51
$851
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.