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 $562.34 Median $954.99 Typical High $2,398.83 | Facility | None | $562.34 | $954.99 | $2,398.83 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $446.68 Typical High $562.34 | Professional | None | $269.15 | $446.68 | $562.34 |
Ambetter Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | None | $269.15 | $269.15 | $269.15 |
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 $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | None | $1,258.93 | $1,258.93 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $186.21 Median $229.09 Typical High $501.19 | Facility | None | $186.21 | $229.09 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $302.00 Typical High $794.33 | Professional | None | $245.47 | $302.00 | $794.33 |
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 $208.93 Median $275.42 Typical High $407.38 | Professional | None | $208.93 | $275.42 | $407.38 |
8 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 $190.55 Median $223.87 Typical High $281.84 | Professional | 52 · Reduced service | $190.55 | $223.87 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $91.20 Typical High $112.20 | Professional | 53 · Discontinued | $75.86 | $91.20 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $338.84 Typical High $426.58 | Professional | 54 · Surgery only | $288.40 | $338.84 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $67.61 Typical High $85.11 | Professional | 55 · Aftercare only | $57.54 | $67.61 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $44.67 Typical High $56.23 | Professional | 56 · Pre-op care only | $38.02 | $44.67 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $316.23 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $269.15 | $316.23 | $398.11 |
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 |
BCBS Alabama Setting Professional Modifier 32 · Mandated service Typical Low $407.38 Median $501.19 Typical High $645.65 | Professional | 32 · Mandated service | $407.38 | $501.19 | $645.65 |
Where Alabama sits
The same service costs 4.2 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· 11th of 51
$447
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.