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 $776.25 Median $1,258.93 Typical High $2,398.83 | Facility | None | $776.25 | $1,258.93 | $2,398.83 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $575.44 | Professional | None | $380.19 | $380.19 | $575.44 |
BCBS Alabama Setting Facility Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $1,949.84 | Facility | None | $1,949.84 | $1,949.84 | $1,949.84 |
BCBS Alabama Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | None | $302.00 | $302.00 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $234.42 Median $288.40 Typical High $501.19 | Facility | None | $234.42 | $288.40 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $269.15 Typical High $363.08 | Professional | None | $204.17 | $269.15 | $363.08 |
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 $173.78 Median $263.03 Typical High $363.08 | Professional | None | $173.78 | $263.03 | $363.08 |
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 $190.55 Typical High $288.40 | Professional | 52 · Reduced service | $190.55 | $190.55 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $75.86 Typical High $114.82 | Professional | 53 · Discontinued | $75.86 | $75.86 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $281.84 Typical High $436.52 | Professional | 54 · Surgery only | $281.84 | $281.84 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $57.54 Typical High $87.10 | Professional | 55 · Aftercare only | $57.54 | $57.54 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $38.02 Typical High $57.54 | Professional | 56 · Pre-op care only | $38.02 | $38.02 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $263.03 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $263.03 | $263.03 | $407.38 |
BCBS Alabama Setting Facility Modifier 50 · Both sides Typical Low $2,951.21 Median $2,951.21 Typical High $2,951.21 | Facility | 50 · Both sides | $2,951.21 | $2,951.21 | $2,951.21 |
BCBS Alabama Setting Professional Modifier 32 · Mandated service Typical Low $218.78 Median $302.00 Typical High $407.38 | Professional | 32 · Mandated service | $218.78 | $302.00 | $407.38 |
Where Alabama sits
The same service costs 4.3 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· 16th of 51
$380
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.