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 $131.83 Median $512.86 Typical High $1,862.09 | Facility | None | $131.83 | $512.86 | $1,862.09 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $512.86 | Professional | None | $229.09 | $229.09 | $512.86 |
Ambetter Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | None | $131.83 | $131.83 | $131.83 |
BCBS Alabama Setting Facility Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Facility | None | $239.88 | $239.88 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $109.65 Typical High $446.68 | Facility | None | $50.12 | $109.65 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $218.78 Typical High $302.00 | Professional | None | $138.04 | $218.78 | $302.00 |
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 $112.20 Median $234.42 Typical High $380.19 | Professional | None | $112.20 | $234.42 | $380.19 |
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 $112.20 Median $112.20 Typical High $257.04 | Professional | 52 · Reduced service | $112.20 | $112.20 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $45.71 Typical High $104.71 | Professional | 53 · Discontinued | $45.71 | $45.71 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $169.82 Typical High $389.05 | Professional | 54 · Surgery only | $169.82 | $169.82 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $33.88 Typical High $77.62 | Professional | 55 · Aftercare only | $33.88 | $33.88 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $22.91 Typical High $51.29 | Professional | 56 · Pre-op care only | $22.91 | $22.91 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $158.49 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $158.49 | $158.49 | $363.08 |
BCBS Alabama Setting Professional Modifier 32 · Mandated service Typical Low $229.09 Median $316.23 Typical High $457.09 | Professional | 32 · Mandated service | $229.09 | $316.23 | $457.09 |
Where Alabama sits
The same service costs 3.6 times more in Wisconsin 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· 39th of 51
$240
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.