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 $1,174.90 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,174.90 | $1,737.80 | $1,737.80 |
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 $977.24 Median $977.24 Typical High $977.24 | Professional | None | $977.24 | $977.24 | $977.24 |
BCBS Alabama Setting Professional Modifier 32 · Mandated service Typical Low $707.95 Median $977.24 Typical High $1,230.27 | Professional | 32 · Mandated service | $707.95 | $977.24 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $1,659.59 Typical High $2,041.74 | Facility | None | $549.54 | $1,659.59 | $2,041.74 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $831.76 Typical High $1,023.29 | Professional | None | $707.95 | $831.76 | $1,023.29 |
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 $676.08 Median $812.83 Typical High $1,096.48 | Professional | None | $676.08 | $812.83 | $1,096.48 |
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 $630.96 Median $870.96 Typical High $870.96 | Professional | 52 · Reduced service | $630.96 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $346.74 Typical High $346.74 | Professional | 53 · Discontinued | $257.04 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,318.26 Typical High $1,318.26 | Professional | 54 · Surgery only | $954.99 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $263.03 Typical High $263.03 | Professional | 55 · Aftercare only | $190.55 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $173.78 Typical High $173.78 | Professional | 56 · Pre-op care only | $125.89 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $1,230.27 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $891.25 | $1,230.27 | $1,230.27 |
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 8.1 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
$1,738
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.