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 $234.42 Median $257.04 Typical High $446.68 | Professional | None | $234.42 | $257.04 | $446.68 |
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 None Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | None | $218.78 | $218.78 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $199.53 Typical High $501.19 | Facility | None | $162.18 | $199.53 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $173.78 Typical High $239.88 | Professional | None | $151.36 | $173.78 | $239.88 |
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 $107.15 Median $173.78 Typical High $295.12 | Professional | None | $107.15 | $173.78 | $295.12 |
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 $128.82 Median $128.82 Typical High $223.87 | Professional | 52 · Reduced service | $128.82 | $128.82 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $52.48 Typical High $89.13 | Professional | 53 · Discontinued | $52.48 | $52.48 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $194.98 Typical High $331.13 | Professional | 54 · Surgery only | $194.98 | $194.98 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $38.90 Typical High $66.07 | Professional | 55 · Aftercare only | $38.90 | $38.90 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $25.70 Typical High $44.67 | Professional | 56 · Pre-op care only | $25.70 | $25.70 | $44.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $181.97 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $181.97 | $181.97 | $309.03 |
BCBS Alabama Setting Professional Modifier 32 · Mandated service Typical Low $158.49 Median $218.78 Typical High $316.23 | Professional | 32 · Mandated service | $158.49 | $218.78 | $316.23 |
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· 21st of 51
$240
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.