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 $245.47 Median $281.84 Typical High $478.63 | Professional | None | $245.47 | $281.84 | $478.63 |
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 $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $234.42 Typical High $501.19 | Facility | None | $190.55 | $234.42 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $173.78 Typical High $257.04 | Professional | None | $109.65 | $173.78 | $257.04 |
United Setting Facility Modifier None Typical Low $100.00 Median $371.54 Typical High $1,380.38 | Facility | None | $100.00 | $371.54 | $1,380.38 |
United Setting Professional Modifier None Typical Low $112.20 Median $186.21 Typical High $302.00 | Professional | None | $112.20 | $186.21 | $302.00 |
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 $141.25 Median $141.25 Typical High $239.88 | Professional | 52 · Reduced service | $141.25 | $141.25 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $56.23 Typical High $95.50 | Professional | 53 · Discontinued | $56.23 | $56.23 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $208.93 Typical High $354.81 | Professional | 54 · Surgery only | $208.93 | $208.93 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $41.69 Typical High $70.79 | Professional | 55 · Aftercare only | $41.69 | $41.69 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $28.18 Typical High $47.86 | Professional | 56 · Pre-op care only | $28.18 | $28.18 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $194.98 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $194.98 | $194.98 | $331.13 |
BCBS Alabama Setting Professional Modifier 32 · Mandated service Typical Low $165.96 Median $229.09 Typical High $323.59 | Professional | 32 · Mandated service | $165.96 | $229.09 | $323.59 |
Where Alabama sits
The same service costs 3.5 times more in Alaska than in Washington, DC. 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· 21st of 51
$257
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.