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 $275.42 Median $426.58 Typical High $446.68 | Professional | None | $275.42 | $426.58 | $446.68 |
BCBS Alabama Setting Facility Modifier None Typical Low $645.65 Median $645.65 Typical High $645.65 | Facility | None | $645.65 | $645.65 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $128.82 Median $158.49 Typical High $501.19 | Facility | None | $128.82 | $158.49 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $295.12 Typical High $354.81 | Professional | None | $245.47 | $295.12 | $354.81 |
United Setting Facility Modifier None Typical Low $100.00 Median $363.08 Typical High $1,380.38 | Facility | None | $100.00 | $363.08 | $1,380.38 |
United Setting Professional Modifier None Typical Low $204.17 Median $245.47 Typical High $407.38 | Professional | None | $204.17 | $245.47 | $407.38 |
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 $213.80 Median $213.80 Typical High $223.87 | Professional | 52 · Reduced service | $213.80 | $213.80 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $87.10 Typical High $89.13 | Professional | 53 · Discontinued | $87.10 | $87.10 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $323.59 Typical High $338.84 | Professional | 54 · Surgery only | $323.59 | $323.59 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $64.57 Typical High $67.61 | Professional | 55 · Aftercare only | $64.57 | $64.57 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $42.66 Typical High $44.67 | Professional | 56 · Pre-op care only | $42.66 | $42.66 | $44.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $302.00 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $302.00 | $302.00 | $316.23 |
BCBS Alabama Setting Facility Modifier 50 · Both sides Typical Low $977.24 Median $977.24 Typical High $977.24 | Facility | 50 · Both sides | $977.24 | $977.24 | $977.24 |
BCBS Alabama Setting Professional Modifier 32 · Mandated service Typical Low $190.55 Median $257.04 Typical High $363.08 | Professional | 32 · Mandated service | $190.55 | $257.04 | $363.08 |
Where Alabama sits
The same service costs 5.9 times more in Alaska than in Texas. 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· 31st of 51
$309
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.