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 $524.81 Median $724.44 Typical High $724.44 | Professional | None | $524.81 | $724.44 | $724.44 |
BCBS Alabama Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | None | $457.09 | $457.09 | $457.09 |
BCBS Alabama Setting Professional Modifier 32 · Mandated service Typical Low $338.84 Median $457.09 Typical High $549.54 | Professional | 32 · Mandated service | $338.84 | $457.09 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $549.54 Typical High $1,202.26 | Facility | None | $446.68 | $549.54 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $398.11 Typical High $478.63 | Professional | None | $338.84 | $398.11 | $478.63 |
United Setting Facility Modifier None Typical Low $371.54 Median $954.99 Typical High $3,801.89 | Facility | None | $371.54 | $954.99 | $3,801.89 |
United Setting Professional Modifier None Typical Low $309.03 Median $363.08 Typical High $489.78 | Professional | None | $309.03 | $363.08 | $489.78 |
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 $363.08 Typical High $363.08 | Professional | 52 · Reduced service | $263.03 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $144.54 Typical High $144.54 | Professional | 53 · Discontinued | $104.71 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $549.54 Typical High $549.54 | Professional | 54 · Surgery only | $389.05 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $109.65 Typical High $109.65 | Professional | 55 · Aftercare only | $77.62 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $72.44 Typical High $72.44 | Professional | 56 · Pre-op care only | $52.48 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $512.86 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $363.08 | $512.86 | $512.86 |
Where Alabama sits
The same service costs 6.9 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· 24th of 51
$501
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.