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 $407.38 Median $478.63 Typical High $588.84 | Professional | None | $407.38 | $478.63 | $588.84 |
Ambetter Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | None | $93.33 | $93.33 | $93.33 |
BCBS Alabama Setting Facility Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Facility | None | $1,348.96 | $1,348.96 | $1,348.96 |
BCBS Alabama Setting Professional Modifier None Typical Low $398.11 Median $512.86 Typical High $575.44 | Professional | None | $398.11 | $512.86 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $177.83 Median $218.78 Typical High $501.19 | Facility | None | $177.83 | $218.78 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $316.23 Typical High $512.86 | Professional | None | $263.03 | $316.23 | $512.86 |
United Setting Facility Modifier None Typical Low $309.03 Median $616.60 Typical High $2,511.89 | Facility | None | $309.03 | $616.60 | $2,511.89 |
United Setting Professional Modifier None Typical Low $218.78 Median $281.84 Typical High $371.54 | Professional | None | $218.78 | $281.84 | $371.54 |
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 $204.17 Median $239.88 Typical High $295.12 | Professional | 52 · Reduced service | $204.17 | $239.88 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $95.50 Typical High $117.49 | Professional | 53 · Discontinued | $81.28 | $95.50 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $363.08 Typical High $436.52 | Professional | 54 · Surgery only | $302.00 | $363.08 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $72.44 Typical High $87.10 | Professional | 55 · Aftercare only | $60.26 | $72.44 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $47.86 Typical High $58.88 | Professional | 56 · Pre-op care only | $40.74 | $47.86 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $338.84 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $281.84 | $338.84 | $407.38 |
BCBS Alabama Setting Facility Modifier 50 · Both sides Typical Low $1,995.26 Median $2,041.74 Typical High $2,041.74 | Facility | 50 · Both sides | $1,995.26 | $2,041.74 | $2,041.74 |
Where Alabama sits
The same service costs 5.2 times more in Alaska 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
$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.