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 $302.00 Median $478.63 Typical High $512.86 | Professional | None | $302.00 | $478.63 | $512.86 |
Ambetter Setting Professional Modifier None Typical Low $275.42 Median $426.58 Typical High $426.58 | Professional | None | $275.42 | $426.58 | $426.58 |
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 $309.03 Median $363.08 Typical High $407.38 | Professional | None | $309.03 | $363.08 | $407.38 |
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 $229.09 Median $281.84 Typical High $457.09 | Professional | None | $229.09 | $281.84 | $457.09 |
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 $234.42 Median $234.42 Typical High $257.04 | Professional | 52 · Reduced service | $234.42 | $234.42 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $95.50 Typical High $102.33 | Professional | 53 · Discontinued | $95.50 | $95.50 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $354.81 Typical High $389.05 | Professional | 54 · Surgery only | $354.81 | $354.81 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $70.79 Typical High $77.62 | Professional | 55 · Aftercare only | $70.79 | $70.79 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $47.86 Typical High $51.29 | Professional | 56 · Pre-op care only | $47.86 | $47.86 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $331.13 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $331.13 | $331.13 | $363.08 |
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 $281.84 Median $389.05 Typical High $426.58 | Professional | 32 · Mandated service | $281.84 | $389.05 | $426.58 |
Where Alabama sits
The same service costs 5.5 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· 26th of 51
$372
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.