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 $436.52 Median $1,023.29 Typical High $2,187.76 | Facility | None | $436.52 | $1,023.29 | $2,187.76 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $436.52 Typical High $436.52 | Professional | None | $223.87 | $436.52 | $436.52 |
Ambetter Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $141.25 | Professional | None | $95.50 | $95.50 | $141.25 |
BCBS Alabama Setting Facility Modifier None Typical Low $2,884.03 Median $2,951.21 Typical High $2,951.21 | Facility | None | $2,884.03 | $2,951.21 | $2,951.21 |
BCBS Alabama Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | None | $323.59 | $323.59 | $323.59 |
BCBS Alabama Setting Professional Modifier 32 · Mandated service Typical Low $239.88 Median $323.59 Typical High $363.08 | Professional | 32 · Mandated service | $239.88 | $323.59 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,479.11 Typical High $2,041.74 | Facility | None | $645.65 | $1,479.11 | $2,041.74 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $239.88 Typical High $316.23 | Professional | None | $218.78 | $239.88 | $316.23 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,737.80 Typical High $4,168.69 | Facility | None | $758.58 | $1,737.80 | $4,168.69 |
United Setting Professional Modifier None Typical Low $158.49 Median $199.53 Typical High $380.19 | Professional | None | $158.49 | $199.53 | $380.19 |
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 $213.80 Median $213.80 Typical High $213.80 | Professional | 52 · Reduced service | $213.80 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | 53 · Discontinued | $87.10 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | 54 · Surgery only | $323.59 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | 55 · Aftercare only | $64.57 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | 56 · Pre-op care only | $43.65 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $302.00 | $302.00 | $302.00 |
Where Alabama sits
The same service costs 5.6 times more in Alaska than in Utah. 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· 23rd of 51
$282
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.