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 $676.08 Median $977.24 Typical High $977.24 | Professional | None | $676.08 | $977.24 | $977.24 |
BCBS Alabama Setting Facility Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Facility | None | $2,398.83 | $2,398.83 | $2,398.83 |
BCBS Alabama Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | None | $616.60 | $616.60 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $1,737.80 Typical High $2,041.74 | Facility | None | $741.31 | $1,737.80 | $2,041.74 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $524.81 Typical High $645.65 | Professional | None | $446.68 | $524.81 | $645.65 |
United Setting Facility Modifier None Typical Low $1,096.48 Median $2,454.71 Typical High $5,248.07 | Facility | None | $1,096.48 | $2,454.71 | $5,248.07 |
United Setting Professional Modifier None Typical Low $416.87 Median $478.63 Typical High $645.65 | Professional | None | $416.87 | $478.63 | $645.65 |
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 $346.74 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $346.74 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $138.04 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $724.44 Typical High $724.44 | Professional | 54 · Surgery only | $524.81 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $104.71 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $69.18 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $676.08 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $489.78 | $676.08 | $676.08 |
BCBS Alabama Setting Facility Modifier 50 · Both sides Typical Low $3,630.78 Median $3,630.78 Typical High $3,630.78 | Facility | 50 · Both sides | $3,630.78 | $3,630.78 | $3,630.78 |
BCBS Alabama Setting Professional Modifier 32 · Mandated service Typical Low $446.68 Median $616.60 Typical High $741.31 | Professional | 32 · Mandated service | $446.68 | $616.60 | $741.31 |
Where Alabama sits
The same service costs 7.9 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· 11th of 51
$977
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.