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 $251.19 Median $251.19 Typical High $398.11 | Professional | None | $251.19 | $251.19 | $398.11 |
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 |
BCBS Alabama Setting Professional Modifier None Typical Low $181.97 Median $251.19 Typical High $338.84 | Professional | None | $181.97 | $251.19 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $177.83 Median $218.78 Typical High $501.19 | Facility | None | $177.83 | $218.78 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $234.42 Typical High $295.12 | Professional | None | $158.49 | $234.42 | $295.12 |
United Setting Facility Modifier None Typical Low $309.03 Median $616.60 Typical High $2,511.89 | Facility | None | $309.03 | $616.60 | $2,511.89 |
United Setting Professional Modifier None Typical Low $128.82 Median $204.17 Typical High $346.74 | Professional | None | $128.82 | $204.17 | $346.74 |
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 $125.89 Median $125.89 Typical High $199.53 | Professional | 52 · Reduced service | $125.89 | $125.89 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $50.12 Typical High $79.43 | Professional | 53 · Discontinued | $50.12 | $50.12 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $186.21 Typical High $302.00 | Professional | 54 · Surgery only | $186.21 | $186.21 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $37.15 Typical High $60.26 | Professional | 55 · Aftercare only | $37.15 | $37.15 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $25.12 Typical High $39.81 | Professional | 56 · Pre-op care only | $25.12 | $25.12 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $173.78 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $173.78 | $173.78 | $281.84 |
Where Alabama sits
The same service costs 4.4 times more in Alaska than in Kentucky. 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· 30th of 51
$251
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.