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 $190.55 Median $331.13 Typical High $1,862.09 | Facility | None | $190.55 | $331.13 | $1,862.09 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $229.09 Typical High $331.13 | Professional | None | $199.53 | $229.09 | $331.13 |
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 $141.25 Median $194.98 Typical High $295.12 | Professional | 32 · Mandated service | $141.25 | $194.98 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $102.33 Typical High $512.86 | Facility | None | $50.12 | $102.33 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $173.78 Typical High $251.19 | Professional | None | $117.49 | $173.78 | $251.19 |
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 $154.88 Typical High $269.15 | Professional | None | $93.33 | $154.88 | $269.15 |
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 $100.00 Median $114.82 Typical High $165.96 | Professional | 52 · Reduced service | $100.00 | $114.82 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $45.71 Typical High $66.07 | Professional | 53 · Discontinued | $39.81 | $45.71 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $169.82 Typical High $251.19 | Professional | 54 · Surgery only | $147.91 | $169.82 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $33.88 Typical High $50.12 | Professional | 55 · Aftercare only | $30.20 | $33.88 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $22.91 Typical High $33.11 | Professional | 56 · Pre-op care only | $19.95 | $22.91 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $158.49 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $138.04 | $158.49 | $234.42 |
Where Alabama sits
The same service costs 4.5 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· 40th of 51
$191
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.