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 $645.65 Median $1,230.27 Typical High $2,398.83 | Facility | None | $645.65 | $1,230.27 | $2,398.83 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $741.31 Typical High $1,047.13 | Professional | None | $691.83 | $741.31 | $1,047.13 |
BCBS Alabama Setting Facility Modifier None Typical Low $4,265.80 Median $4,265.80 Typical High $4,265.80 | Facility | None | $4,265.80 | $4,265.80 | $4,265.80 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $1,412.54 Typical High $1,737.80 | Facility | None | $489.78 | $1,412.54 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $478.63 Typical High $616.60 | Professional | None | $354.81 | $478.63 | $616.60 |
United Setting Facility Modifier None Typical Low $467.74 Median $1,000.00 Typical High $3,235.94 | Facility | None | $467.74 | $1,000.00 | $3,235.94 |
United Setting Professional Modifier None Typical Low $302.00 Median $426.58 Typical High $660.69 | Professional | None | $302.00 | $426.58 | $660.69 |
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 $346.74 Median $371.54 Typical High $524.81 | Professional | 52 · Reduced service | $346.74 | $371.54 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $147.91 Typical High $208.93 | Professional | 53 · Discontinued | $138.04 | $147.91 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $562.34 Typical High $776.25 | Professional | 54 · Surgery only | $524.81 | $562.34 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $112.20 Typical High $154.88 | Professional | 55 · Aftercare only | $104.71 | $112.20 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $74.13 Typical High $104.71 | Professional | 56 · Pre-op care only | $69.18 | $74.13 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $524.81 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $489.78 | $524.81 | $724.44 |
BCBS Alabama Setting Professional Modifier 32 · Mandated service Typical Low $446.68 Median $616.60 Typical High $776.25 | Professional | 32 · Mandated service | $446.68 | $616.60 | $776.25 |
Where Alabama sits
The same service costs 4.4 times more in Alaska than in Texas. 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· 13th of 51
$724
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.