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 $109.65 Median $199.53 Typical High $199.53 | Professional | None | $109.65 | $199.53 | $199.53 |
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 |
BCBS Alabama Setting Professional Modifier 32 · Mandated service Typical Low $85.11 Median $117.49 Typical High $158.49 | Professional | 32 · Mandated service | $85.11 | $117.49 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $91.20 Typical High $446.68 | Facility | None | $50.12 | $91.20 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $141.25 Typical High $169.82 | Professional | None | $117.49 | $141.25 | $169.82 |
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 $93.33 Median $112.20 Typical High $186.21 | Professional | None | $93.33 | $112.20 | $186.21 |
6 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 $61.66 Median $100.00 Typical High $100.00 | Professional | 52 · Reduced service | $61.66 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $39.81 Typical High $39.81 | Professional | 53 · Discontinued | $24.55 | $39.81 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $151.36 Typical High $151.36 | Professional | 54 · Surgery only | $91.20 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $30.20 Typical High $30.20 | Professional | 55 · Aftercare only | $18.62 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $19.95 Typical High $19.95 | Professional | 56 · Pre-op care only | $12.30 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $85.11 Median $141.25 Typical High $141.25 | Professional | 78 · Unplanned return to OR | $85.11 | $141.25 | $141.25 |
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· 33rd of 51
$145
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.