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 $154.88 Median $154.88 Typical High $218.78 | Professional | None | $154.88 | $154.88 | $218.78 |
BCBS Alabama Setting Facility Modifier None Typical Low $3,311.31 Median $3,311.31 Typical High $3,311.31 | Facility | None | $3,311.31 | $3,311.31 | $3,311.31 |
BCBS Alabama Setting Professional Modifier 32 · Mandated service Typical Low $114.82 Median $158.49 Typical High $245.47 | Professional | 32 · Mandated service | $114.82 | $158.49 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $87.10 Median $107.15 Typical High $933.25 | Facility | None | $87.10 | $107.15 | $933.25 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $141.25 Typical High $194.98 | Professional | None | $102.33 | $141.25 | $194.98 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,737.80 Typical High $4,168.69 | Facility | None | $758.58 | $1,737.80 | $4,168.69 |
United Setting Professional Modifier None Typical Low $95.50 Median $138.04 Typical High $181.97 | Professional | None | $95.50 | $138.04 | $181.97 |
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 $75.86 Median $75.86 Typical High $109.65 | Professional | 52 · Reduced service | $75.86 | $75.86 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $30.90 Typical High $43.65 | Professional | 53 · Discontinued | $30.90 | $30.90 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $114.82 Typical High $165.96 | Professional | 54 · Surgery only | $114.82 | $114.82 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $22.91 Typical High $33.11 | Professional | 55 · Aftercare only | $22.91 | $22.91 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $15.49 Typical High $21.88 | Professional | 56 · Pre-op care only | $15.49 | $15.49 | $21.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $107.15 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $107.15 | $107.15 | $154.88 |
Where Alabama sits
The same service costs 3.6 times more in Wisconsin 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· 39th of 51
$162
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.