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 $251.19 Median $251.19 Typical High $295.12 | Professional | None | $251.19 | $251.19 | $295.12 |
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 $50.12 Median $134.90 Typical High $446.68 | Facility | None | $50.12 | $134.90 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $199.53 Typical High $234.42 | Professional | None | $169.82 | $199.53 | $234.42 |
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 $120.23 Median $151.36 Typical High $257.04 | Professional | None | $120.23 | $151.36 | $257.04 |
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 $147.91 | Professional | 52 · Reduced service | $125.89 | $125.89 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $50.12 Typical High $58.88 | Professional | 53 · Discontinued | $50.12 | $50.12 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $186.21 Typical High $223.87 | Professional | 54 · Surgery only | $186.21 | $186.21 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $37.15 Typical High $44.67 | Professional | 55 · Aftercare only | $37.15 | $37.15 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $25.12 Typical High $29.51 | Professional | 56 · Pre-op care only | $25.12 | $25.12 | $29.51 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $173.78 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $173.78 | $173.78 | $208.93 |
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 $134.90 Median $186.21 Typical High $239.88 | Professional | 32 · Mandated service | $134.90 | $186.21 | $239.88 |
Where Alabama sits
The same service costs 4.6 times more in Alaska than in Florida. 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· 27th of 51
$209
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.