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 $323.59 Median $323.59 Typical High $389.05 | Professional | None | $323.59 | $323.59 | $389.05 |
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 $173.78 Median $199.53 Typical High $251.19 | Professional | None | $173.78 | $199.53 | $251.19 |
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 $154.88 Median $181.97 Typical High $316.23 | Professional | None | $154.88 | $181.97 | $316.23 |
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 $162.18 Median $162.18 Typical High $194.98 | Professional | 52 · Reduced service | $162.18 | $162.18 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $64.57 Typical High $77.62 | Professional | 53 · Discontinued | $64.57 | $64.57 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $245.47 Typical High $288.40 | Professional | 54 · Surgery only | $245.47 | $245.47 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $48.98 Typical High $57.54 | Professional | 55 · Aftercare only | $48.98 | $48.98 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $32.36 Typical High $38.90 | Professional | 56 · Pre-op care only | $32.36 | $32.36 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $229.09 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $229.09 | $229.09 | $269.15 |
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 $162.18 Median $223.87 Typical High $309.03 | Professional | 32 · Mandated service | $162.18 | $223.87 | $309.03 |
Where Alabama sits
The same service costs 5.0 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· 33rd of 51
$234
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.