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 $281.84 Median $389.05 Typical High $562.34 | Professional | None | $281.84 | $389.05 | $562.34 |
Ambetter Setting Professional Modifier None Typical Low $165.96 Median $309.03 Typical High $416.87 | Professional | None | $165.96 | $309.03 | $416.87 |
BCBS Alabama Setting Facility Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,137.96 | Facility | None | $2,137.96 | $2,137.96 | $2,137.96 |
BCBS Alabama Setting Professional Modifier None Typical Low $199.53 Median $275.42 Typical High $398.11 | Professional | None | $199.53 | $275.42 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $229.09 Median $281.84 Typical High $501.19 | Facility | None | $229.09 | $281.84 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $213.80 Typical High $288.40 | Professional | None | $181.97 | $213.80 | $288.40 |
United Setting Facility Modifier None Typical Low $309.03 Median $616.60 Typical High $2,511.89 | Facility | None | $309.03 | $616.60 | $2,511.89 |
United Setting Professional Modifier None Typical Low $158.49 Median $223.87 Typical High $371.54 | Professional | None | $158.49 | $223.87 | $371.54 |
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 $194.98 Median $194.98 Typical High $281.84 | Professional | 52 · Reduced service | $194.98 | $194.98 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $77.62 Typical High $112.20 | Professional | 53 · Discontinued | $77.62 | $77.62 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $295.12 Typical High $426.58 | Professional | 54 · Surgery only | $295.12 | $295.12 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $58.88 Typical High $85.11 | Professional | 55 · Aftercare only | $58.88 | $58.88 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $38.90 Typical High $56.23 | Professional | 56 · Pre-op care only | $38.90 | $38.90 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $275.42 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $275.42 | $275.42 | $398.11 |
Where Alabama sits
The same service costs 3.8 times more in Alaska than in Kentucky. 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· 28th of 51
$288
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.