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 $776.25 Median $1,258.93 Typical High $2,630.27 | Facility | None | $776.25 | $1,258.93 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $478.63 Typical High $501.19 | Professional | None | $302.00 | $478.63 | $501.19 |
Ambetter Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | None | $302.00 | $302.00 | $302.00 |
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 $50.12 Median $134.90 Typical High $446.68 | Facility | None | $50.12 | $134.90 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $316.23 Typical High $380.19 | Professional | None | $239.88 | $316.23 | $380.19 |
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 $218.78 Median $263.03 Typical High $436.52 | Professional | None | $218.78 | $263.03 | $436.52 |
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 $354.81 Median $354.81 Typical High $371.54 | Professional | 54 · Surgery only | $354.81 | $354.81 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $70.79 Typical High $74.13 | Professional | 55 · Aftercare only | $70.79 | $70.79 | $74.13 |
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 $331.13 Median $331.13 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $331.13 | $331.13 | $346.74 |
BCBS Alabama Setting Professional Modifier 32 · Mandated service Typical Low $208.93 Median $288.40 Typical High $398.11 | Professional | 32 · Mandated service | $208.93 | $288.40 | $398.11 |
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· 31st of 51
$339
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.