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 $588.84 Median $1,513.56 Typical High $2,398.83 | Professional | None | $588.84 | $1,513.56 | $2,398.83 |
BCBS Alabama Setting Facility Modifier None Typical Low $1,621.81 Median $1,659.59 Typical High $1,659.59 | Facility | None | $1,621.81 | $1,659.59 | $1,659.59 |
BCBS Alabama Setting Professional Modifier None Typical Low $1,071.52 Median $1,479.11 Typical High $2,041.74 | Professional | None | $1,071.52 | $1,479.11 | $2,041.74 |
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 $316.23 Median $489.78 Typical High $1,949.84 | Professional | None | $316.23 | $489.78 | $1,949.84 |
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 $295.12 Median $1,071.52 Typical High $1,621.81 | Professional | None | $295.12 | $1,071.52 | $1,621.81 |
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 $295.12 Median $758.58 Typical High $1,202.26 | Professional | 52 · Reduced service | $295.12 | $758.58 | $1,202.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $302.00 Typical High $478.63 | Professional | 53 · Discontinued | $117.49 | $302.00 | $478.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $1,122.02 Typical High $1,778.28 | Professional | 54 · Surgery only | $446.68 | $1,122.02 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $223.87 Typical High $363.08 | Professional | 55 · Aftercare only | $89.13 | $223.87 | $363.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $151.36 Typical High $239.88 | Professional | 56 · Pre-op care only | $58.88 | $151.36 | $239.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $1,047.13 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $416.87 | $1,047.13 | $1,659.59 |
BCBS Alabama Setting Facility Modifier 50 · Both sides Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Facility | 50 · Both sides | $2,454.71 | $2,454.71 | $2,454.71 |
Where Alabama sits
The same service costs 5.8 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· 29th of 51
$1,479
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.