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 $512.86 Median $602.56 Typical High $891.25 | Professional | None | $512.86 | $602.56 | $891.25 |
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 $457.09 Median $457.09 Typical High $457.09 | Professional | None | $457.09 | $457.09 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $1,047.13 Typical High $1,288.25 | Facility | None | $549.54 | $1,047.13 | $1,288.25 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $338.84 Typical High $467.74 | Professional | None | $257.04 | $338.84 | $467.74 |
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 $257.04 Median $363.08 Typical High $537.03 | Professional | None | $257.04 | $363.08 | $537.03 |
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 $302.00 Median $302.00 Typical High $446.68 | Professional | 52 · Reduced service | $302.00 | $302.00 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $120.23 Typical High $177.83 | Professional | 53 · Discontinued | $120.23 | $120.23 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $446.68 Typical High $660.69 | Professional | 54 · Surgery only | $446.68 | $446.68 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $89.13 Typical High $131.83 | Professional | 55 · Aftercare only | $89.13 | $89.13 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $60.26 Typical High $89.13 | Professional | 56 · Pre-op care only | $60.26 | $60.26 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $416.87 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $416.87 | $416.87 | $616.60 |
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 $331.13 Median $457.09 Typical High $616.60 | Professional | 32 · Mandated service | $331.13 | $457.09 | $616.60 |
Where Alabama sits
The same service costs 5.9 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· 15th of 51
$603
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.