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 $91.20 Median $125.89 Typical High $186.21 | Professional | None | $91.20 | $125.89 | $186.21 |
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 $85.11 Median $104.71 Typical High $630.96 | Facility | None | $85.11 | $104.71 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $107.15 Typical High $125.89 | Professional | None | $87.10 | $107.15 | $125.89 |
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 $61.66 Median $87.10 Typical High $151.36 | Professional | None | $61.66 | $87.10 | $151.36 |
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 $63.10 Median $63.10 Typical High $93.33 | Professional | 52 · Reduced service | $63.10 | $63.10 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $25.12 Typical High $37.15 | Professional | 53 · Discontinued | $25.12 | $25.12 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $93.33 Typical High $138.04 | Professional | 54 · Surgery only | $93.33 | $93.33 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $19.05 Typical High $27.54 | Professional | 55 · Aftercare only | $19.05 | $19.05 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $12.59 Typical High $18.62 | Professional | 56 · Pre-op care only | $12.59 | $12.59 | $18.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $87.10 Typical High $128.82 | Professional | 78 · Unplanned return to OR | $87.10 | $87.10 | $128.82 |
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 $79.43 Median $109.65 Typical High $154.88 | Professional | 32 · Mandated service | $79.43 | $109.65 | $154.88 |
Where Alabama sits
The same service costs 3.7 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· 25th of 51
$126
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.