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 $141.25 Median $177.83 Typical High $223.87 | Professional | None | $141.25 | $177.83 | $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 None Typical Low $97.72 Median $134.90 Typical High $199.53 | Professional | None | $97.72 | $134.90 | $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 $97.72 Median $134.90 Typical High $199.53 | Professional | None | $97.72 | $134.90 | $199.53 |
United Setting Facility Modifier None Typical Low $100.00 Median $363.08 Typical High $1,380.38 | Facility | None | $100.00 | $363.08 | $1,380.38 |
United Setting Professional Modifier None Typical Low $89.13 Median $123.03 Typical High $177.83 | Professional | None | $89.13 | $123.03 | $177.83 |
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 $89.13 Median $89.13 Typical High $112.20 | Professional | 52 · Reduced service | $89.13 | $89.13 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $35.48 Typical High $44.67 | Professional | 53 · Discontinued | $35.48 | $35.48 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $131.83 Typical High $169.82 | Professional | 54 · Surgery only | $131.83 | $131.83 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $26.30 Typical High $33.88 | Professional | 55 · Aftercare only | $26.30 | $26.30 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $17.78 Typical High $22.39 | Professional | 56 · Pre-op care only | $17.78 | $17.78 | $22.39 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $123.03 Typical High $158.49 | Professional | 78 · Unplanned return to OR | $123.03 | $123.03 | $158.49 |
Where Alabama sits
The same service costs 4.1 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· 32nd of 51
$155
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.