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 $645.65 Median $1,230.27 Typical High $2,398.83 | Facility | None | $645.65 | $1,230.27 | $2,398.83 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $501.19 Typical High $707.95 | Professional | None | $436.52 | $501.19 | $707.95 |
BCBS Alabama Setting Facility Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $3,162.28 | Facility | None | $3,162.28 | $3,162.28 | $3,162.28 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $331.13 Typical High $933.25 | Facility | None | $269.15 | $331.13 | $933.25 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $467.74 Typical High $549.54 | Professional | None | $363.08 | $467.74 | $549.54 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,737.80 Typical High $4,073.80 | Facility | None | $758.58 | $1,737.80 | $4,073.80 |
United Setting Professional Modifier None Typical Low $251.19 Median $371.54 Typical High $630.96 | Professional | None | $251.19 | $371.54 | $630.96 |
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 $251.19 Median $251.19 Typical High $354.81 | Professional | 52 · Reduced service | $251.19 | $251.19 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $100.00 Typical High $141.25 | Professional | 53 · Discontinued | $100.00 | $100.00 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $380.19 Typical High $537.03 | Professional | 54 · Surgery only | $380.19 | $380.19 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $75.86 Typical High $107.15 | Professional | 55 · Aftercare only | $75.86 | $75.86 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $50.12 Typical High $70.79 | Professional | 56 · Pre-op care only | $50.12 | $50.12 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $354.81 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $354.81 | $354.81 | $501.19 |
BCBS Alabama Setting Facility Modifier 50 · Both sides Typical Low $4,677.35 Median $4,786.30 Typical High $4,786.30 | Facility | 50 · Both sides | $4,677.35 | $4,786.30 | $4,786.30 |
BCBS Alabama Setting Professional Modifier 32 · Mandated service Typical Low $398.11 Median $537.03 Typical High $588.84 | Professional | 32 · Mandated service | $398.11 | $537.03 | $588.84 |
Where Alabama sits
The same service costs 4.5 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· 22nd of 51
$501
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.