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 $389.05 Median $478.63 Typical High $501.19 | Professional | None | $389.05 | $478.63 | $501.19 |
Ambetter Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | None | $354.81 | $354.81 | $354.81 |
BCBS Alabama Setting Facility Modifier None Typical Low $645.65 Median $645.65 Typical High $645.65 | Facility | None | $645.65 | $645.65 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $128.82 Median $158.49 Typical High $501.19 | Facility | None | $128.82 | $158.49 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $346.74 Typical High $407.38 | Professional | None | $295.12 | $346.74 | $407.38 |
United Setting Facility Modifier None Typical Low $100.00 Median $363.08 Typical High $1,380.38 | Facility | None | $100.00 | $363.08 | $1,380.38 |
United Setting Professional Modifier None Typical Low $229.09 Median $275.42 Typical High $457.09 | Professional | None | $229.09 | $275.42 | $457.09 |
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 $239.88 Median $239.88 Typical High $251.19 | Professional | 52 · Reduced service | $239.88 | $239.88 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $95.50 Typical High $100.00 | Professional | 53 · Discontinued | $95.50 | $95.50 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $363.08 Typical High $380.19 | Professional | 54 · Surgery only | $363.08 | $363.08 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $72.44 Typical High $75.86 | Professional | 55 · Aftercare only | $72.44 | $72.44 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $47.86 Typical High $50.12 | Professional | 56 · Pre-op care only | $47.86 | $47.86 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $338.84 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $338.84 | $338.84 | $354.81 |
BCBS Alabama Setting Professional Modifier 32 · Mandated service Typical Low $251.19 Median $346.74 Typical High $426.58 | Professional | 32 · Mandated service | $251.19 | $346.74 | $426.58 |
Where Alabama sits
The same service costs 5.5 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· 29th of 51
$363
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.