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 $316.23 Median $776.25 Typical High $1,905.46 | Facility | None | $316.23 | $776.25 | $1,905.46 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $416.87 Typical High $512.86 | Professional | None | $363.08 | $416.87 | $512.86 |
Ambetter Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $416.87 | Professional | None | $199.53 | $199.53 | $416.87 |
BCBS Alabama Setting Facility Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,019.95 | Facility | None | $3,019.95 | $3,019.95 | $3,019.95 |
BCBS Alabama Setting Professional Modifier 32 · Mandated service Typical Low $275.42 Median $380.19 Typical High $524.81 | Professional | 32 · Mandated service | $275.42 | $380.19 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $1,000.00 Typical High $1,174.90 | Facility | None | $489.78 | $1,000.00 | $1,174.90 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $380.19 Typical High $549.54 | Professional | None | $239.88 | $380.19 | $549.54 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,737.80 Typical High $4,073.80 | Facility | None | $758.58 | $1,737.80 | $4,073.80 |
United Setting Professional Modifier None Typical Low $194.98 Median $295.12 Typical High $537.03 | Professional | None | $194.98 | $295.12 | $537.03 |
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 $186.21 Typical High $257.04 | Professional | 52 · Reduced service | $181.97 | $186.21 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $74.13 Typical High $102.33 | Professional | 53 · Discontinued | $72.44 | $74.13 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $275.42 Typical High $389.05 | Professional | 54 · Surgery only | $275.42 | $275.42 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $54.95 Typical High $77.62 | Professional | 55 · Aftercare only | $54.95 | $54.95 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $37.15 Typical High $51.29 | Professional | 56 · Pre-op care only | $36.31 | $37.15 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $257.04 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $257.04 | $257.04 | $363.08 |
Where Alabama sits
The same service costs 4.6 times more in Alaska 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· 31st of 51
$417
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.