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 $173.78 Median $173.78 Typical High $245.47 | Professional | None | $173.78 | $173.78 | $245.47 |
BCBS Alabama Setting Facility Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Facility | None | $162.18 | $162.18 | $162.18 |
BCBS Alabama Setting Professional Modifier 32 · Mandated service Typical Low $104.71 Median $141.25 Typical High $213.80 | Professional | 32 · Mandated service | $104.71 | $141.25 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $109.65 Median $134.90 Typical High $501.19 | Facility | None | $109.65 | $134.90 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $138.04 Typical High $204.17 | Professional | None | $95.50 | $138.04 | $204.17 |
United Setting Facility Modifier None Typical Low $467.74 Median $1,000.00 Typical High $3,162.28 | Facility | None | $467.74 | $1,000.00 | $3,162.28 |
United Setting Professional Modifier None Typical Low $83.18 Median $125.89 Typical High $213.80 | Professional | None | $83.18 | $125.89 | $213.80 |
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 $85.11 Median $85.11 Typical High $123.03 | Professional | 52 · Reduced service | $85.11 | $85.11 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $34.67 Typical High $48.98 | Professional | 53 · Discontinued | $34.67 | $34.67 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $128.82 Typical High $186.21 | Professional | 54 · Surgery only | $128.82 | $128.82 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $25.70 Typical High $37.15 | Professional | 55 · Aftercare only | $25.70 | $25.70 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $17.38 Typical High $24.55 | Professional | 56 · Pre-op care only | $17.38 | $17.38 | $24.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $120.23 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $120.23 | $120.23 | $173.78 |
Where Alabama sits
The same service costs 4.4 times more in Alaska than in Kentucky. 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
$162
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.