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 $794.33 Median $1,513.56 Typical High $2,398.83 | Facility | None | $794.33 | $1,513.56 | $2,398.83 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $1,096.48 Typical High $1,096.48 | Professional | None | $724.44 | $1,096.48 | $1,096.48 |
BCBS Alabama Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Facility | None | $776.25 | $776.25 | $776.25 |
BCBS Alabama Setting Professional Modifier None Typical Low $478.63 Median $660.69 Typical High $794.33 | Professional | None | $478.63 | $660.69 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,096.48 Typical High $1,548.82 | Facility | None | $645.65 | $1,096.48 | $1,548.82 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $575.44 Typical High $691.83 | Professional | None | $478.63 | $575.44 | $691.83 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,737.80 Typical High $4,073.80 | Facility | None | $758.58 | $1,737.80 | $4,073.80 |
United Setting Professional Modifier None Typical Low $457.09 Median $537.03 Typical High $724.44 | Professional | None | $457.09 | $537.03 | $724.44 |
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 $398.11 Median $549.54 Typical High $549.54 | Professional | 52 · Reduced service | $398.11 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $218.78 Typical High $218.78 | Professional | 53 · Discontinued | $158.49 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $831.76 Typical High $831.76 | Professional | 54 · Surgery only | $588.84 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $165.96 Typical High $165.96 | Professional | 55 · Aftercare only | $117.49 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $109.65 Typical High $109.65 | Professional | 56 · Pre-op care only | $79.43 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $776.25 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $549.54 | $776.25 | $776.25 |
BCBS Alabama Setting Facility Modifier 50 · Both sides Typical Low $1,148.15 Median $1,174.90 Typical High $1,174.90 | Facility | 50 · Both sides | $1,148.15 | $1,174.90 | $1,174.90 |
Where Alabama sits
The same service costs 8.5 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· 27th of 51
$776
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.