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 $794.33 Median $1,513.56 Typical High $2,398.83 | Facility | None | $794.33 | $1,513.56 | $2,398.83 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,698.24 | Professional | None | $1,348.96 | $1,348.96 | $1,698.24 |
BCBS Alabama Setting Facility Modifier None Typical Low $5,011.87 Median $5,128.61 Typical High $5,128.61 | Facility | None | $5,011.87 | $5,128.61 | $5,128.61 |
BCBS Alabama Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Professional | None | $1,047.13 | $1,047.13 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,884.03 Typical High $3,548.13 | Facility | None | $645.65 | $2,884.03 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $870.96 Typical High $977.24 | Professional | None | $812.83 | $870.96 | $977.24 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,737.80 Typical High $4,265.80 | Facility | None | $758.58 | $1,737.80 | $4,265.80 |
United Setting Professional Modifier None Typical Low $549.54 Median $776.25 Typical High $1,230.27 | Professional | None | $549.54 | $776.25 | $1,230.27 |
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 $676.08 Median $676.08 Typical High $851.14 | Professional | 52 · Reduced service | $676.08 | $676.08 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $269.15 Typical High $338.84 | Professional | 53 · Discontinued | $269.15 | $269.15 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,023.29 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,023.29 | $1,023.29 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $204.17 Typical High $257.04 | Professional | 55 · Aftercare only | $204.17 | $204.17 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $134.90 Typical High $169.82 | Professional | 56 · Pre-op care only | $134.90 | $134.90 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $954.99 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $954.99 | $954.99 | $1,202.26 |
BCBS Alabama Setting Professional Modifier 32 · Mandated service Typical Low $758.58 Median $1,047.13 Typical High $1,318.26 | Professional | 32 · Mandated service | $758.58 | $1,047.13 | $1,318.26 |
Where Alabama sits
The same service costs 4.4 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· 25th of 51
$977
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.