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 $407.38 Median $467.74 Typical High $588.84 | Professional | None | $407.38 | $467.74 | $588.84 |
BCBS Setting Facility Modifier None Typical Low $1,318.26 Median $1,348.96 Typical High $1,348.96 | Facility | None | $1,318.26 | $1,348.96 | $1,348.96 |
BCBS Setting Professional Modifier 32 · Mandated service Typical Low $213.80 Median $295.12 Typical High $446.68 | Professional | 32 · Mandated service | $213.80 | $295.12 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $281.84 Median $346.74 Typical High $630.96 | Facility | None | $281.84 | $346.74 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $295.12 Typical High $407.38 | Professional | None | $208.93 | $295.12 | $407.38 |
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 $177.83 Median $263.03 Typical High $489.78 | Professional | None | $177.83 | $263.03 | $489.78 |
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 $204.17 Median $204.17 Typical High $288.40 | Professional | 52 · Reduced service | $204.17 | $204.17 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $81.28 Typical High $117.49 | Professional | 53 · Discontinued | $81.28 | $81.28 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $309.03 Typical High $436.52 | Professional | 54 · Surgery only | $309.03 | $309.03 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $61.66 Typical High $87.10 | Professional | 55 · Aftercare only | $61.66 | $61.66 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $40.74 Typical High $58.88 | Professional | 56 · Pre-op care only | $40.74 | $40.74 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $288.40 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $288.40 | $288.40 | $407.38 |
Where Alabama sits
The same service costs 3.7 times more in Wisconsin 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· 14th of 51
$407
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.