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 $645.65 Median $1,230.27 Typical High $2,398.83 | Facility | None | $645.65 | $1,230.27 | $2,398.83 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $416.87 | Professional | None | $363.08 | $363.08 | $416.87 |
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 $147.91 Median $204.17 Typical High $302.00 | Professional | None | $147.91 | $204.17 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $1,621.81 Typical High $2,041.74 | Facility | None | $489.78 | $1,621.81 | $2,041.74 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $213.80 Typical High $331.13 | Professional | None | $181.97 | $213.80 | $331.13 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,737.80 Typical High $4,265.80 | Facility | None | $758.58 | $1,737.80 | $4,265.80 |
United Setting Professional Modifier None Typical Low $151.36 Median $204.17 Typical High $302.00 | Professional | None | $151.36 | $204.17 | $302.00 |
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 $181.97 Median $181.97 Typical High $208.93 | Professional | 52 · Reduced service | $181.97 | $181.97 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $72.44 Typical High $83.18 | Professional | 53 · Discontinued | $72.44 | $72.44 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $275.42 Typical High $309.03 | Professional | 54 · Surgery only | $275.42 | $275.42 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $54.95 Typical High $61.66 | Professional | 55 · Aftercare only | $54.95 | $54.95 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $36.31 Typical High $41.69 | Professional | 56 · Pre-op care only | $36.31 | $36.31 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $257.04 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $257.04 | $257.04 | $288.40 |
Where Alabama sits
The same service costs 5.9 times more in Oklahoma 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· 33rd of 51
$269
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.