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 $562.34 Median $954.99 Typical High $2,398.83 | Facility | None | $562.34 | $954.99 | $2,398.83 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $177.83 Typical High $251.19 | Professional | None | $151.36 | $177.83 | $251.19 |
Ambetter Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $251.19 | Professional | None | $141.25 | $141.25 | $251.19 |
BCBS Alabama Setting Facility Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $3,548.13 | Facility | None | $3,548.13 | $3,548.13 | $3,548.13 |
BCBS Alabama Setting Professional Modifier 32 · Mandated service Typical Low $131.83 Median $177.83 Typical High $275.42 | Professional | 32 · Mandated service | $131.83 | $177.83 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $147.91 Typical High $933.25 | Facility | None | $120.23 | $147.91 | $933.25 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $141.25 Typical High $199.53 | Professional | None | $120.23 | $141.25 | $199.53 |
United Setting Facility Modifier None Typical Low $467.74 Median $1,000.00 Typical High $3,162.28 | Facility | None | $467.74 | $1,000.00 | $3,162.28 |
United Setting Professional Modifier None Typical Low $104.71 Median $144.54 Typical High $199.53 | Professional | None | $104.71 | $144.54 | $199.53 |
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 $125.89 | Professional | 52 · Reduced service | $89.13 | $89.13 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $35.48 Typical High $50.12 | Professional | 53 · Discontinued | $35.48 | $35.48 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $134.90 Typical High $190.55 | Professional | 54 · Surgery only | $134.90 | $134.90 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $26.92 Typical High $38.02 | Professional | 55 · Aftercare only | $26.92 | $26.92 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $17.78 Typical High $25.12 | Professional | 56 · Pre-op care only | $17.78 | $17.78 | $25.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $125.89 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $125.89 | $125.89 | $177.83 |
Where Alabama sits
The same service costs 3.9 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· 39th of 51
$178
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.