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 $245.47 Median $245.47 Typical High $363.08 | Professional | None | $245.47 | $245.47 | $363.08 |
BCBS Alabama Setting Facility Modifier None Typical Low $1,230.27 Median $1,258.93 Typical High $1,258.93 | Facility | None | $1,230.27 | $1,258.93 | $1,258.93 |
BCBS Alabama Setting Professional Modifier None Typical Low $194.98 Median $269.15 Typical High $338.84 | Professional | None | $194.98 | $269.15 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $489.78 Typical High $676.08 | Facility | None | $363.08 | $489.78 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $269.15 Typical High $331.13 | Professional | None | $223.87 | $269.15 | $331.13 |
United Setting Facility Modifier None Typical Low $309.03 Median $616.60 Typical High $2,511.89 | Facility | None | $309.03 | $616.60 | $2,511.89 |
United Setting Professional Modifier None Typical Low $131.83 Median $204.17 Typical High $398.11 | Professional | None | $131.83 | $204.17 | $398.11 |
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 $123.03 Median $123.03 Typical High $181.97 | Professional | 52 · Reduced service | $123.03 | $123.03 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $48.98 Typical High $74.13 | Professional | 53 · Discontinued | $48.98 | $48.98 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $186.21 Typical High $275.42 | Professional | 54 · Surgery only | $186.21 | $186.21 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $37.15 Typical High $54.95 | Professional | 55 · Aftercare only | $37.15 | $37.15 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $24.55 Typical High $36.31 | Professional | 56 · Pre-op care only | $24.55 | $24.55 | $36.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $173.78 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $173.78 | $173.78 | $257.04 |
Where Alabama sits
The same service costs 4.2 times more in Alaska than in Virginia. 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· 26th of 51
$269
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.