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 $776.25 Median $1,258.93 Typical High $2,398.83 | Facility | None | $776.25 | $1,258.93 | $2,398.83 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $707.95 | Professional | None | $537.03 | $537.03 | $707.95 |
BCBS Alabama Setting Facility Modifier None Typical Low $4,365.16 Median $4,365.16 Typical High $4,365.16 | Facility | None | $4,365.16 | $4,365.16 | $4,365.16 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $1,412.54 Typical High $1,737.80 | Facility | None | $549.54 | $1,412.54 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $478.63 Typical High $575.44 | Professional | None | $389.05 | $478.63 | $575.44 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $3,311.31 Typical High $6,309.57 | Facility | None | $1,288.25 | $3,311.31 | $6,309.57 |
United Setting Professional Modifier None Typical Low $263.03 Median $354.81 Typical High $602.56 | Professional | None | $263.03 | $354.81 | $602.56 |
8 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 $354.81 | Professional | 52 · Reduced service | $263.03 | $263.03 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $107.15 Typical High $141.25 | Professional | 53 · Discontinued | $107.15 | $107.15 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $398.11 Typical High $537.03 | Professional | 54 · Surgery only | $398.11 | $398.11 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $79.43 Typical High $107.15 | Professional | 55 · Aftercare only | $79.43 | $79.43 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $53.70 Typical High $70.79 | Professional | 56 · Pre-op care only | $53.70 | $53.70 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $371.54 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $371.54 | $371.54 | $501.19 |
BCBS Alabama Setting Facility Modifier 50 · Both sides Typical Low $6,456.54 Median $6,606.93 Typical High $6,606.93 | Facility | 50 · Both sides | $6,456.54 | $6,606.93 | $6,606.93 |
BCBS Alabama Setting Professional Modifier 32 · Mandated service Typical Low $346.74 Median $467.74 Typical High $616.60 | Professional | 32 · Mandated service | $346.74 | $467.74 | $616.60 |
Where Alabama sits
The same service costs 5.0 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· 20th of 51
$537
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.