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 $489.78 Median $933.25 Typical High $1,862.09 | Facility | None | $489.78 | $933.25 | $1,862.09 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $218.78 Typical High $407.38 | Professional | None | $213.80 | $218.78 | $407.38 |
Ambetter Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
BCBS Alabama 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 Alabama Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | None | $208.93 | $208.93 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $660.69 Typical High $794.33 | Facility | None | $363.08 | $660.69 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $190.55 Typical High $229.09 | Professional | None | $123.03 | $190.55 | $229.09 |
United Setting Facility Modifier None Typical Low $467.74 Median $1,000.00 Typical High $3,162.28 | Facility | None | $467.74 | $1,000.00 | $3,162.28 |
United Setting Professional Modifier None Typical Low $89.13 Median $165.96 Typical High $269.15 | Professional | None | $89.13 | $165.96 | $269.15 |
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 $109.65 Median $109.65 Typical High $204.17 | Professional | 52 · Reduced service | $109.65 | $109.65 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $43.65 Typical High $83.18 | Professional | 53 · Discontinued | $43.65 | $43.65 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $162.18 Typical High $309.03 | Professional | 54 · Surgery only | $162.18 | $162.18 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $32.36 Typical High $61.66 | Professional | 55 · Aftercare only | $32.36 | $32.36 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $21.88 Typical High $40.74 | Professional | 56 · Pre-op care only | $21.88 | $21.88 | $40.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $151.36 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $151.36 | $151.36 | $288.40 |
BCBS Alabama Setting Professional Modifier 32 · Mandated service Typical Low $151.36 Median $208.93 Typical High $295.12 | Professional | 32 · Mandated service | $151.36 | $208.93 | $295.12 |
Where Alabama sits
The same service costs 3.3 times more in Alaska than in Washington, DC. 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
$219
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.