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 $169.82 Median $169.82 Typical High $223.87 | Professional | None | $169.82 | $169.82 | $223.87 |
BCBS Alabama Setting Facility Modifier None Typical Low $549.54 Median $562.34 Typical High $562.34 | Facility | None | $549.54 | $562.34 | $562.34 |
BCBS Alabama Setting Professional Modifier 32 · Mandated service Typical Low $97.72 Median $131.83 Typical High $199.53 | Professional | 32 · Mandated service | $97.72 | $131.83 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $102.33 Typical High $512.86 | Facility | None | $50.12 | $102.33 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $131.83 Typical High $194.98 | Professional | None | $93.33 | $131.83 | $194.98 |
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 $87.10 Median $117.49 Typical High $165.96 | Professional | None | $87.10 | $117.49 | $165.96 |
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 $85.11 Median $85.11 Typical High $112.20 | Professional | 52 · Reduced service | $85.11 | $85.11 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $33.88 Typical High $44.67 | Professional | 53 · Discontinued | $33.88 | $33.88 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $125.89 Typical High $169.82 | Professional | 54 · Surgery only | $125.89 | $125.89 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $25.12 Typical High $33.88 | Professional | 55 · Aftercare only | $25.12 | $25.12 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $16.98 Typical High $22.39 | Professional | 56 · Pre-op care only | $16.98 | $16.98 | $22.39 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $117.49 Typical High $158.49 | Professional | 78 · Unplanned return to OR | $117.49 | $117.49 | $158.49 |
Where Alabama sits
The same service costs 4.2 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· 25th of 51
$170
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.