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 $794.33 Median $954.99 Typical High $1,000.00 | Professional | None | $794.33 | $954.99 | $1,000.00 |
BCBS Alabama Setting Facility Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Facility | None | $1,584.89 | $1,584.89 | $1,584.89 |
BCBS Alabama Setting Professional Modifier None Typical Low $724.44 Median $891.25 Typical High $1,148.15 | Professional | None | $724.44 | $891.25 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $288.40 Median $354.81 Typical High $501.19 | Facility | None | $288.40 | $354.81 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $549.54 Typical High $1,230.27 | Professional | None | $467.74 | $549.54 | $1,230.27 |
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 $426.58 Median $512.86 Typical High $912.01 | Professional | None | $426.58 | $512.86 | $912.01 |
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 $363.08 Median $478.63 Typical High $501.19 | Professional | 52 · Reduced service | $363.08 | $478.63 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $190.55 Typical High $204.17 | Professional | 53 · Discontinued | $144.54 | $190.55 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $724.44 Typical High $758.58 | Professional | 54 · Surgery only | $549.54 | $724.44 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $144.54 Typical High $151.36 | Professional | 55 · Aftercare only | $109.65 | $144.54 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $95.50 Typical High $100.00 | Professional | 56 · Pre-op care only | $72.44 | $95.50 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $676.08 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $512.86 | $676.08 | $707.95 |
BCBS Alabama Setting Facility Modifier 50 · Both sides Typical Low $2,344.23 Median $2,398.83 Typical High $2,398.83 | Facility | 50 · Both sides | $2,344.23 | $2,398.83 | $2,398.83 |
Where Alabama sits
The same service costs 6.2 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· 13th of 51
$912
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.