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 $398.11 Median $467.74 Typical High $691.83 | Professional | None | $398.11 | $467.74 | $691.83 |
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 $263.03 Median $323.59 Typical High $933.25 | Facility | None | $263.03 | $323.59 | $933.25 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $371.54 Typical High $512.86 | Professional | None | $338.84 | $371.54 | $512.86 |
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 $234.42 Median $354.81 Typical High $602.56 | Professional | None | $234.42 | $354.81 | $602.56 |
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 $338.84 | Professional | 52 · Reduced service | $234.42 | $234.42 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $93.33 Typical High $138.04 | Professional | 53 · Discontinued | $93.33 | $93.33 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $354.81 Typical High $512.86 | Professional | 54 · Surgery only | $354.81 | $354.81 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $70.79 Typical High $102.33 | Professional | 55 · Aftercare only | $70.79 | $70.79 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $46.77 Typical High $69.18 | Professional | 56 · Pre-op care only | $46.77 | $46.77 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $331.13 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $331.13 | $331.13 | $478.63 |
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 $309.03 Median $426.58 Typical High $575.44 | Professional | 32 · Mandated service | $309.03 | $426.58 | $575.44 |
Where Alabama sits
The same service costs 4.7 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· 24th of 51
$468
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.