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 $2,398.83 | Facility | None | $776.25 | $1,258.93 | $2,398.83 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $467.74 Typical High $512.86 | Professional | None | $316.23 | $467.74 | $512.86 |
BCBS Alabama Setting Facility Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $3,162.28 | Facility | None | $3,162.28 | $3,162.28 | $3,162.28 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $870.96 Typical High $1,096.48 | Facility | None | $549.54 | $870.96 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $346.74 Typical High $436.52 | Professional | None | $269.15 | $346.74 | $436.52 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,737.80 Typical High $4,073.80 | Facility | None | $758.58 | $1,737.80 | $4,073.80 |
United Setting Professional Modifier None Typical Low $229.09 Median $288.40 Typical High $478.63 | Professional | None | $229.09 | $288.40 | $478.63 |
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 $229.09 Median $229.09 Typical High $257.04 | Professional | 52 · Reduced service | $229.09 | $229.09 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $93.33 Typical High $102.33 | Professional | 53 · Discontinued | $93.33 | $93.33 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $346.74 Typical High $389.05 | Professional | 54 · Surgery only | $346.74 | $346.74 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $69.18 Typical High $77.62 | Professional | 55 · Aftercare only | $69.18 | $69.18 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $46.77 Typical High $51.29 | Professional | 56 · Pre-op care only | $46.77 | $46.77 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $323.59 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $323.59 | $323.59 | $363.08 |
BCBS Alabama Setting Professional Modifier 32 · Mandated service Typical Low $223.87 Median $309.03 Typical High $426.58 | Professional | 32 · Mandated service | $223.87 | $309.03 | $426.58 |
Where Alabama sits
The same service costs 6.8 times more in Alaska than in Utah. 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
$437
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.