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 $501.19 Median $1,096.48 Typical High $2,089.30 | Facility | None | $501.19 | $1,096.48 | $2,089.30 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $501.19 Typical High $501.19 | Professional | None | $407.38 | $501.19 | $501.19 |
Ambetter Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | None | $275.42 | $275.42 | $275.42 |
BCBS Alabama Setting Facility Modifier None Typical Low $6,165.95 Median $6,165.95 Typical High $6,165.95 | Facility | None | $6,165.95 | $6,165.95 | $6,165.95 |
BCBS Alabama Setting Professional Modifier None Typical Low $467.74 Median $562.34 Typical High $645.65 | Professional | None | $467.74 | $562.34 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $2,884.03 Typical High $3,548.13 | Facility | None | $549.54 | $2,884.03 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $398.11 Typical High $645.65 | Professional | None | $354.81 | $398.11 | $645.65 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $3,801.89 Typical High $8,317.64 | Facility | None | $1,698.24 | $3,801.89 | $8,317.64 |
United Setting Professional Modifier None Typical Low $288.40 Median $363.08 Typical High $501.19 | Professional | None | $288.40 | $363.08 | $501.19 |
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 $251.19 Median $251.19 Typical High $251.19 | Professional | 52 · Reduced service | $251.19 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | 53 · Discontinued | $100.00 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | 54 · Surgery only | $380.19 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | 55 · Aftercare only | $75.86 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | 56 · Pre-op care only | $50.12 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $354.81 | $354.81 | $354.81 |
Where Alabama sits
The same service costs 9.3 times more in Kansas 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· 29th of 51
$562
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.