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 $776.25 Median $1,258.93 Typical High $2,630.27 | Facility | None | $776.25 | $1,258.93 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $8,317.64 Median $8,317.64 Typical High $8,317.64 | Professional | None | $8,317.64 | $8,317.64 | $8,317.64 |
BCBS Alabama Setting Facility Modifier None Typical Low $3,235.94 Median $3,311.31 Typical High $3,311.31 | Facility | None | $3,235.94 | $3,311.31 | $3,311.31 |
BCBS Alabama Setting Professional Modifier None Typical Low $3,019.95 Median $4,168.69 Typical High $6,025.60 | Professional | None | $3,019.95 | $4,168.69 | $6,025.60 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $549.54 Typical High $1,202.26 | Facility | None | $446.68 | $549.54 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $3,801.89 Median $4,265.80 Typical High $5,248.07 | Professional | None | $3,801.89 | $4,265.80 | $5,248.07 |
United Setting Facility Modifier None Typical Low $371.54 Median $954.99 Typical High $3,801.89 | Facility | None | $371.54 | $954.99 | $3,801.89 |
United Setting Professional Modifier None Typical Low $3,162.28 Median $4,168.69 Typical High $7,244.36 | Professional | None | $3,162.28 | $4,168.69 | $7,244.36 |
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 $4,168.69 Median $4,168.69 Typical High $4,168.69 | Professional | 52 · Reduced service | $4,168.69 | $4,168.69 | $4,168.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Professional | 53 · Discontinued | $1,659.59 | $1,659.59 | $1,659.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $6,309.57 Median $6,309.57 Typical High $6,309.57 | Professional | 54 · Surgery only | $6,309.57 | $6,309.57 | $6,309.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | 55 · Aftercare only | $1,258.93 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | 56 · Pre-op care only | $831.76 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $5,888.44 Median $5,888.44 Typical High $5,888.44 | Professional | 78 · Unplanned return to OR | $5,888.44 | $5,888.44 | $5,888.44 |
Where Alabama sits
The same service costs 21.9 times more in Alaska than in Texas. 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· 37th of 51
$4,266
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.