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 $218.78 Median $218.78 Typical High $346.74 | Professional | None | $218.78 | $218.78 | $346.74 |
BCBS Alabama Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Facility | None | $85.11 | $85.11 | $85.11 |
BCBS Alabama Setting Professional Modifier None Typical Low $125.89 Median $169.82 Typical High $245.47 | Professional | None | $125.89 | $169.82 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $125.89 Typical High $446.68 | Facility | None | $50.12 | $125.89 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $169.82 Typical High $251.19 | Professional | None | $128.82 | $169.82 | $251.19 |
United Setting Facility Modifier None Typical Low $100.00 Median $371.54 Typical High $1,380.38 | Facility | None | $100.00 | $371.54 | $1,380.38 |
United Setting Professional Modifier None Typical Low $89.13 Median $141.25 Typical High $234.42 | Professional | None | $89.13 | $141.25 | $234.42 |
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 $109.65 Median $109.65 Typical High $173.78 | Professional | 52 · Reduced service | $109.65 | $109.65 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $43.65 Typical High $69.18 | Professional | 53 · Discontinued | $43.65 | $43.65 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $165.96 Typical High $263.03 | Professional | 54 · Surgery only | $165.96 | $165.96 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $33.11 Typical High $52.48 | Professional | 55 · Aftercare only | $33.11 | $33.11 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $21.88 Typical High $34.67 | Professional | 56 · Pre-op care only | $21.88 | $21.88 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $154.88 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $154.88 | $154.88 | $245.47 |
Where Alabama sits
The same service costs 3.5 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· 26th of 51
$178
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.