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 $741.31 Median $1,148.15 Typical High $2,454.71 | Professional | None | $741.31 | $1,148.15 | $2,454.71 |
BCBS Alabama Setting Facility Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $2,238.72 | Facility | None | $2,238.72 | $2,238.72 | $2,238.72 |
BCBS Alabama Setting Professional Modifier None Typical Low $891.25 Median $1,202.26 Typical High $2,238.72 | Professional | None | $891.25 | $1,202.26 | $2,238.72 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $1,174.90 Typical High $1,659.59 | Facility | None | $549.54 | $1,174.90 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $1,621.81 Typical High $2,630.27 | Professional | None | $660.69 | $1,621.81 | $2,630.27 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $3,311.31 Typical High $6,309.57 | Facility | None | $1,288.25 | $3,311.31 | $6,309.57 |
United Setting Professional Modifier None Typical Low $323.59 Median $1,122.02 Typical High $2,511.89 | Professional | None | $323.59 | $1,122.02 | $2,511.89 |
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 $371.54 Median $575.44 Typical High $1,230.27 | Professional | 52 · Reduced service | $371.54 | $575.44 | $1,230.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $229.09 Typical High $501.19 | Professional | 53 · Discontinued | $151.36 | $229.09 | $501.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $870.96 Typical High $1,862.09 | Professional | 54 · Surgery only | $562.34 | $870.96 | $1,862.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $173.78 Typical High $371.54 | Professional | 55 · Aftercare only | $112.20 | $173.78 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $114.82 Typical High $245.47 | Professional | 56 · Pre-op care only | $74.13 | $114.82 | $245.47 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $812.83 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $524.81 | $812.83 | $1,737.80 |
Where Alabama sits
The same service costs 4.9 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· 17th of 51
$1,698
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.