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 $891.25 Median $1,348.96 Typical High $2,398.83 | Facility | None | $891.25 | $1,348.96 | $2,398.83 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $524.81 Typical High $588.84 | Professional | None | $426.58 | $524.81 | $588.84 |
BCBS Alabama Setting Facility Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $2,570.40 | Facility | None | $2,570.40 | $2,570.40 | $2,570.40 |
BCBS Alabama Setting Professional Modifier 12 Typical Low $302.00 Median $416.87 Typical High $630.96 | Professional | 12 | $302.00 | $416.87 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $1,737.80 Typical High $2,041.74 | Facility | None | $741.31 | $1,737.80 | $2,041.74 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $398.11 Typical High $537.03 | Professional | None | $338.84 | $398.11 | $537.03 |
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 $295.12 Median $389.05 Typical High $549.54 | Professional | None | $295.12 | $389.05 | $549.54 |
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 $263.03 Median $263.03 Typical High $295.12 | Professional | 52 · Reduced service | $263.03 | $263.03 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $104.71 Typical High $120.23 | Professional | 53 · Discontinued | $104.71 | $104.71 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $389.05 Typical High $446.68 | Professional | 54 · Surgery only | $389.05 | $389.05 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $79.43 Typical High $89.13 | Professional | 55 · Aftercare only | $79.43 | $79.43 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $52.48 Typical High $58.88 | Professional | 56 · Pre-op care only | $52.48 | $52.48 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $363.08 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $363.08 | $363.08 | $416.87 |
Where Alabama sits
The same service costs 3.8 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· 28th of 51
$525
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.