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 $234.42 Median $234.42 Typical High $389.05 | Professional | None | $234.42 | $234.42 | $389.05 |
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 $134.90 Median $186.21 Typical High $295.12 | Professional | 32 · Mandated service | $134.90 | $186.21 | $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 $125.89 Median $177.83 Typical High $263.03 | Professional | None | $125.89 | $177.83 | $263.03 |
United Setting Facility Modifier None Typical Low $478.63 Median $1,000.00 Typical High $3,162.28 | Facility | None | $478.63 | $1,000.00 | $3,162.28 |
United Setting Professional Modifier None Typical Low $100.00 Median $173.78 Typical High $309.03 | Professional | None | $100.00 | $173.78 | $309.03 |
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 $117.49 Median $117.49 Typical High $190.55 | Professional | 52 · Reduced service | $117.49 | $117.49 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $47.86 Typical High $77.62 | Professional | 53 · Discontinued | $47.86 | $47.86 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $177.83 Typical High $288.40 | Professional | 54 · Surgery only | $177.83 | $177.83 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $35.48 Typical High $57.54 | Professional | 55 · Aftercare only | $35.48 | $35.48 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $23.44 Typical High $38.90 | Professional | 56 · Pre-op care only | $23.44 | $23.44 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $165.96 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $165.96 | $165.96 | $269.15 |
Where Alabama sits
The same service costs 3.8 times more in Wisconsin than in Hawaii. 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
$204
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.