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 $257.04 Median $257.04 Typical High $398.11 | Professional | None | $257.04 | $257.04 | $398.11 |
BCBS Alabama Setting Facility Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $2,511.89 | Facility | None | $2,511.89 | $2,511.89 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $177.83 Median $218.78 Typical High $501.19 | Facility | None | $177.83 | $218.78 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $218.78 Typical High $295.12 | Professional | None | $162.18 | $218.78 | $295.12 |
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 $346.74 | Professional | None | $131.83 | $204.17 | $346.74 |
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 $125.89 Median $125.89 Typical High $199.53 | Professional | 52 · Reduced service | $125.89 | $125.89 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $51.29 Typical High $79.43 | Professional | 53 · Discontinued | $51.29 | $51.29 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $190.55 Typical High $302.00 | Professional | 54 · Surgery only | $190.55 | $190.55 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $38.02 Typical High $60.26 | Professional | 55 · Aftercare only | $38.02 | $38.02 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $25.70 Typical High $39.81 | Professional | 56 · Pre-op care only | $25.70 | $25.70 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $177.83 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $177.83 | $177.83 | $281.84 |
BCBS Alabama Setting Facility Modifier 50 · Both sides Typical Low $3,801.89 Median $3,801.89 Typical High $3,801.89 | Facility | 50 · Both sides | $3,801.89 | $3,801.89 | $3,801.89 |
BCBS Alabama Setting Professional Modifier 32 · Mandated service Typical Low $181.97 Median $245.47 Typical High $338.84 | Professional | 32 · Mandated service | $181.97 | $245.47 | $338.84 |
Where Alabama sits
The same service costs 3.5 times more in Alaska than in Kentucky. 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· 29th of 51
$257
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.