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 $147.91 Median $223.87 Typical High $288.40 | Professional | None | $147.91 | $223.87 | $288.40 |
Ambetter Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | None | $147.91 | $147.91 | $147.91 |
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 $181.97 Median $181.97 Typical High $181.97 | Professional | None | $181.97 | $181.97 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $95.50 Median $117.49 Typical High $501.19 | Facility | None | $95.50 | $117.49 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $165.96 Typical High $223.87 | Professional | None | $125.89 | $165.96 | $223.87 |
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 $128.82 Typical High $213.80 | Professional | None | $89.13 | $128.82 | $213.80 |
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 $112.20 Median $112.20 Typical High $144.54 | Professional | 52 · Reduced service | $112.20 | $112.20 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $44.67 Typical High $57.54 | Professional | 53 · Discontinued | $44.67 | $44.67 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $165.96 Typical High $213.80 | Professional | 54 · Surgery only | $165.96 | $165.96 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $33.11 Typical High $42.66 | Professional | 55 · Aftercare only | $33.11 | $33.11 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $22.39 Typical High $28.84 | Professional | 56 · Pre-op care only | $22.39 | $22.39 | $28.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $154.88 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $154.88 | $154.88 | $199.53 |
BCBS Alabama Setting Professional Modifier 32 · Mandated service Typical Low $131.83 Median $181.97 Typical High $229.09 | Professional | 32 · Mandated service | $131.83 | $181.97 | $229.09 |
Where Alabama sits
The same service costs 4.0 times more in Alaska than in New Jersey. 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· 24th of 51
$170
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.