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 $645.65 Median $1,230.27 Typical High $2,398.83 | Facility | None | $645.65 | $1,230.27 | $2,398.83 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,096.48 | $1,621.81 | $1,621.81 |
BCBS Alabama Setting Facility Modifier None Typical Low $4,073.80 Median $4,073.80 Typical High $4,073.80 | Facility | None | $4,073.80 | $4,073.80 | $4,073.80 |
BCBS Alabama Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $912.01 | Professional | None | $912.01 | $912.01 | $912.01 |
BCBS Alabama Setting Professional Modifier 32 · Mandated service Typical Low $660.69 Median $912.01 Typical High $1,122.02 | Professional | 32 · Mandated service | $660.69 | $912.01 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $1,659.59 Typical High $2,041.74 | Facility | None | $489.78 | $1,659.59 | $2,041.74 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $758.58 Typical High $954.99 | Professional | None | $645.65 | $758.58 | $954.99 |
United Setting Facility Modifier None Typical Low $1,096.48 Median $2,454.71 Typical High $5,248.07 | Facility | None | $1,096.48 | $2,454.71 | $5,248.07 |
United Setting Professional Modifier None Typical Low $630.96 Median $758.58 Typical High $1,023.29 | Professional | None | $630.96 | $758.58 | $1,023.29 |
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 $588.84 Median $812.83 Typical High $812.83 | Professional | 52 · Reduced service | $588.84 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $323.59 Typical High $323.59 | Professional | 53 · Discontinued | $234.42 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $1,230.27 Typical High $1,230.27 | Professional | 54 · Surgery only | $891.25 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $177.83 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $162.18 Typical High $162.18 | Professional | 56 · Pre-op care only | $117.49 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $1,148.15 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $831.76 | $1,148.15 | $1,148.15 |
BCBS Alabama Setting Facility Modifier 50 · Both sides Typical Low $6,025.60 Median $6,165.95 Typical High $6,165.95 | Facility | 50 · Both sides | $6,025.60 | $6,165.95 | $6,165.95 |
Where Alabama sits
The same service costs 8.3 times more in Wyoming than in Utah. 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· 10th of 51
$1,622
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.