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 $208.93 Median $338.84 Typical High $354.81 | Professional | None | $208.93 | $338.84 | $354.81 |
Ambetter Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $263.03 | Professional | None | $117.49 | $117.49 | $263.03 |
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 $208.93 Median $239.88 Typical High $288.40 | Professional | None | $208.93 | $239.88 | $288.40 |
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 $162.18 Median $194.98 Typical High $323.59 | Professional | None | $162.18 | $194.98 | $323.59 |
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 $169.82 Median $169.82 Typical High $177.83 | Professional | 52 · Reduced service | $169.82 | $169.82 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $67.61 Typical High $70.79 | Professional | 53 · Discontinued | $67.61 | $67.61 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $251.19 Typical High $269.15 | Professional | 54 · Surgery only | $251.19 | $251.19 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $50.12 Typical High $53.70 | Professional | 55 · Aftercare only | $50.12 | $50.12 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $33.88 Typical High $35.48 | Professional | 56 · Pre-op care only | $33.88 | $33.88 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $234.42 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $234.42 | $234.42 | $251.19 |
BCBS Alabama Setting Professional Modifier 32 · Mandated service Typical Low $162.18 Median $223.87 Typical High $288.40 | Professional | 32 · Mandated service | $162.18 | $223.87 | $288.40 |
Where Alabama sits
The same service costs 5.1 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· 29th of 51
$257
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.