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 $630.96 Median $831.76 Typical High $1,047.13 | Professional | None | $630.96 | $831.76 | $1,047.13 |
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 $645.65 Median $645.65 Typical High $645.65 | Professional | None | $645.65 | $645.65 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,096.48 Typical High $1,548.82 | Facility | None | $645.65 | $1,096.48 | $1,548.82 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $549.54 Typical High $645.65 | Professional | None | $457.09 | $549.54 | $645.65 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,737.80 Typical High $4,073.80 | Facility | None | $758.58 | $1,737.80 | $4,073.80 |
United Setting Professional Modifier None Typical Low $380.19 Median $489.78 Typical High $645.65 | Professional | None | $380.19 | $489.78 | $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 $354.81 Median $416.87 Typical High $524.81 | Professional | 52 · Reduced service | $354.81 | $416.87 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $169.82 Typical High $208.93 | Professional | 53 · Discontinued | $141.25 | $169.82 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $630.96 Typical High $776.25 | Professional | 54 · Surgery only | $524.81 | $630.96 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $125.89 Typical High $154.88 | Professional | 55 · Aftercare only | $104.71 | $125.89 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $85.11 Typical High $104.71 | Professional | 56 · Pre-op care only | $70.79 | $85.11 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $588.84 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $489.78 | $588.84 | $724.44 |
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 $467.74 Median $645.65 Typical High $776.25 | Professional | 32 · Mandated service | $467.74 | $645.65 | $776.25 |
Where Alabama sits
The same service costs 6.5 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· 12th of 51
$832
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.