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 $776.25 Median $1,258.93 Typical High $2,398.83 | Facility | None | $776.25 | $1,258.93 | $2,398.83 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $1,202.26 Typical High $2,041.74 | Professional | None | $691.83 | $1,202.26 | $2,041.74 |
BCBS Alabama Setting Facility Modifier None Typical Low $3,162.28 Median $3,235.94 Typical High $3,235.94 | Facility | None | $3,162.28 | $3,235.94 | $3,235.94 |
BCBS Alabama Setting Professional Modifier None Typical Low $933.25 Median $1,258.93 Typical High $1,737.80 | Professional | None | $933.25 | $1,258.93 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $1,548.82 Typical High $1,905.46 | Facility | None | $549.54 | $1,548.82 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $575.44 Typical High $1,905.46 | Professional | None | $363.08 | $575.44 | $1,905.46 |
United Setting Facility Modifier None Typical Low $1,096.48 Median $2,454.71 Typical High $5,128.61 | Facility | None | $1,096.48 | $2,454.71 | $5,128.61 |
United Setting Professional Modifier None Typical Low $338.84 Median $1,023.29 Typical High $1,659.59 | Professional | None | $338.84 | $1,023.29 | $1,659.59 |
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 $338.84 Median $645.65 Typical High $1,023.29 | Professional | 52 · Reduced service | $338.84 | $645.65 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $257.04 Typical High $407.38 | Professional | 53 · Discontinued | $138.04 | $257.04 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $977.24 Typical High $1,548.82 | Professional | 54 · Surgery only | $512.86 | $977.24 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $194.98 Typical High $309.03 | Professional | 55 · Aftercare only | $102.33 | $194.98 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $128.82 Typical High $204.17 | Professional | 56 · Pre-op care only | $69.18 | $128.82 | $204.17 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $912.01 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $478.63 | $912.01 | $1,445.44 |
BCBS Alabama Setting Facility Modifier 50 · Both sides Typical Low $4,786.30 Median $4,786.30 Typical High $4,786.30 | Facility | 50 · Both sides | $4,786.30 | $4,786.30 | $4,786.30 |
Where Alabama sits
The same service costs 4.4 times more in Alaska than in Nebraska. 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· 25th of 51
$1,380
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.