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 $891.25 Median $1,348.96 Typical High $2,398.83 | Facility | None | $891.25 | $1,348.96 | $2,398.83 |
Aetna Setting Professional Modifier None Typical Low $1,698.24 Median $2,570.40 Typical High $2,570.40 | Professional | None | $1,698.24 | $2,570.40 | $2,570.40 |
BCBS Alabama Setting Facility Modifier None Typical Low $4,677.35 Median $4,786.30 Typical High $4,786.30 | Facility | None | $4,677.35 | $4,786.30 | $4,786.30 |
BCBS Alabama Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,621.81 | $1,621.81 | $1,621.81 |
BCBS Alabama Setting Professional Modifier 32 · Mandated service Typical Low $1,174.90 Median $1,621.81 Typical High $1,949.84 | Professional | 32 · Mandated service | $1,174.90 | $1,621.81 | $1,949.84 |
United Setting Facility Modifier None Typical Low $1,348.96 Median $3,715.35 Typical High $7,413.10 | Facility | None | $1,348.96 | $3,715.35 | $7,413.10 |
United Setting Professional Modifier None Typical Low $1,096.48 Median $1,258.93 Typical High $1,698.24 | Professional | None | $1,096.48 | $1,258.93 | $1,698.24 |
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 $912.01 Median $1,288.25 Typical High $1,288.25 | Professional | 52 · Reduced service | $912.01 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $363.08 Median $512.86 Typical High $512.86 | Professional | 53 · Discontinued | $363.08 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,380.38 Median $1,905.46 Typical High $1,905.46 | Professional | 54 · Surgery only | $1,380.38 | $1,905.46 | $1,905.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $380.19 Typical High $380.19 | Professional | 55 · Aftercare only | $275.42 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $257.04 Typical High $257.04 | Professional | 56 · Pre-op care only | $181.97 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $1,778.28 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $1,288.25 | $1,778.28 | $1,778.28 |
BCBS Alabama Setting Facility Modifier 50 · Both sides Typical Low $7,079.46 Median $7,079.46 Typical High $7,079.46 | Facility | 50 · Both sides | $7,079.46 | $7,079.46 | $7,079.46 |
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· 9th of 51
$2,570
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.