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 $263.03 Median $380.19 Typical High $426.58 | Professional | None | $263.03 | $380.19 | $426.58 |
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 $257.04 Median $302.00 Typical High $338.84 | Professional | None | $257.04 | $302.00 | $338.84 |
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 $186.21 Median $229.09 Typical High $389.05 | Professional | None | $186.21 | $229.09 | $389.05 |
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 $190.55 Median $190.55 Typical High $213.80 | Professional | 52 · Reduced service | $190.55 | $190.55 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $75.86 Typical High $85.11 | Professional | 53 · Discontinued | $75.86 | $75.86 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $281.84 Typical High $323.59 | Professional | 54 · Surgery only | $281.84 | $281.84 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $57.54 Typical High $64.57 | Professional | 55 · Aftercare only | $57.54 | $57.54 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $38.02 Typical High $42.66 | Professional | 56 · Pre-op care only | $38.02 | $38.02 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $263.03 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $263.03 | $263.03 | $302.00 |
BCBS Alabama Setting Professional Modifier 32 · Mandated service Typical Low $281.84 Median $354.81 Typical High $380.19 | Professional | 32 · Mandated service | $281.84 | $354.81 | $380.19 |
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
$302
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.