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 $263.03 Median $331.13 Typical High $457.09 | Professional | None | $263.03 | $331.13 | $457.09 |
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 $223.87 Median $223.87 Typical High $223.87 | Professional | None | $223.87 | $223.87 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $147.91 Median $181.97 Typical High $933.25 | Facility | None | $147.91 | $181.97 | $933.25 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $218.78 Typical High $263.03 | Professional | None | $190.55 | $218.78 | $263.03 |
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 $134.90 Median $204.17 Typical High $338.84 | Professional | None | $134.90 | $204.17 | $338.84 |
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 $165.96 Median $165.96 Typical High $229.09 | Professional | 52 · Reduced service | $165.96 | $165.96 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $66.07 Typical High $93.33 | Professional | 53 · Discontinued | $66.07 | $66.07 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $251.19 Typical High $346.74 | Professional | 54 · Surgery only | $251.19 | $251.19 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $50.12 Typical High $69.18 | Professional | 55 · Aftercare only | $50.12 | $50.12 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $33.11 Typical High $45.71 | Professional | 56 · Pre-op care only | $33.11 | $33.11 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $234.42 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $234.42 | $234.42 | $323.59 |
BCBS Alabama Setting Professional Modifier 32 · Mandated service Typical Low $162.18 Median $223.87 Typical High $323.59 | Professional | 32 · Mandated service | $162.18 | $223.87 | $323.59 |
Where Alabama sits
The same service costs 3.8 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
$263
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.