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 $316.23 Median $316.23 Typical High $426.58 | Professional | None | $316.23 | $316.23 | $426.58 |
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 $204.17 Median $204.17 Typical High $204.17 | Professional | None | $204.17 | $204.17 | $204.17 |
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 $165.96 Median $173.78 Typical High $234.42 | Professional | None | $165.96 | $173.78 | $234.42 |
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 $125.89 Median $181.97 Typical High $309.03 | Professional | None | $125.89 | $181.97 | $309.03 |
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 $158.49 Median $158.49 Typical High $208.93 | Professional | 52 · Reduced service | $158.49 | $158.49 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $63.10 Typical High $85.11 | Professional | 53 · Discontinued | $63.10 | $63.10 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $234.42 Typical High $316.23 | Professional | 54 · Surgery only | $234.42 | $234.42 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $46.77 Typical High $63.10 | Professional | 55 · Aftercare only | $46.77 | $46.77 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $31.62 Typical High $42.66 | Professional | 56 · Pre-op care only | $31.62 | $31.62 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $218.78 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $218.78 | $218.78 | $295.12 |
BCBS Alabama Setting Professional Modifier 32 · Mandated service Typical Low $151.36 Median $204.17 Typical High $295.12 | Professional | 32 · Mandated service | $151.36 | $204.17 | $295.12 |
Where Alabama sits
The same service costs 4.2 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· 29th of 51
$234
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.