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 $134.90 Median $169.82 Typical High $194.98 | Professional | None | $134.90 | $169.82 | $194.98 |
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 |
BCBS Alabama Setting Professional Modifier None Typical Low $100.00 Median $138.04 Typical High $169.82 | Professional | None | $100.00 | $138.04 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $87.10 Typical High $446.68 | Facility | None | $50.12 | $87.10 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $134.90 Typical High $158.49 | Professional | None | $114.82 | $134.90 | $158.49 |
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 $81.28 Median $100.00 Typical High $169.82 | Professional | None | $81.28 | $100.00 | $169.82 |
7 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 $85.11 Median $85.11 Typical High $97.72 | Professional | 52 · Reduced service | $85.11 | $85.11 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $34.67 Typical High $38.90 | Professional | 53 · Discontinued | $34.67 | $34.67 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $128.82 Typical High $144.54 | Professional | 54 · Surgery only | $128.82 | $128.82 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $25.70 Typical High $29.51 | Professional | 55 · Aftercare only | $25.70 | $25.70 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $16.98 Typical High $19.50 | Professional | 56 · Pre-op care only | $16.98 | $16.98 | $19.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $120.23 Typical High $134.90 | Professional | 78 · Unplanned return to OR | $120.23 | $120.23 | $134.90 |
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 |
Where Alabama sits
The same service costs 4.5 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· 29th of 51
$138
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.