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 $562.34 Median $954.99 Typical High $2,398.83 | Facility | None | $562.34 | $954.99 | $2,398.83 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $489.78 | Professional | None | $323.59 | $323.59 | $489.78 |
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 |
BCBS Alabama Setting Professional Modifier 32 · Mandated service Typical Low $181.97 Median $251.19 Typical High $371.54 | Professional | 32 · Mandated service | $181.97 | $251.19 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $194.98 Median $239.88 Typical High $501.19 | Facility | None | $194.98 | $239.88 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $239.88 Typical High $338.84 | Professional | None | $194.98 | $239.88 | $338.84 |
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 $138.04 Median $223.87 Typical High $398.11 | Professional | None | $138.04 | $223.87 | $398.11 |
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 $162.18 Median $162.18 Typical High $245.47 | Professional | 52 · Reduced service | $162.18 | $162.18 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $64.57 Typical High $100.00 | Professional | 53 · Discontinued | $64.57 | $64.57 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $245.47 Typical High $371.54 | Professional | 54 · Surgery only | $245.47 | $245.47 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $48.98 Typical High $74.13 | Professional | 55 · Aftercare only | $48.98 | $48.98 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $32.36 Typical High $48.98 | Professional | 56 · Pre-op care only | $32.36 | $32.36 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $229.09 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $229.09 | $229.09 | $346.74 |
Where Alabama sits
The same service costs 4.3 times more in Wisconsin 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· 19th of 51
$324
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.