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 $194.98 Median $288.40 Typical High $302.00 | Professional | None | $194.98 | $288.40 | $302.00 |
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 $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
Cigna Setting Facility Modifier None Typical Low $89.13 Median $109.65 Typical High $501.19 | Facility | None | $89.13 | $109.65 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $154.88 Typical High $229.09 | Professional | None | $117.49 | $154.88 | $229.09 |
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 $123.03 Median $144.54 Typical High $199.53 | Professional | None | $123.03 | $144.54 | $199.53 |
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 $109.65 Median $144.54 Typical High $151.36 | Professional | 52 · Reduced service | $109.65 | $144.54 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $57.54 Typical High $60.26 | Professional | 53 · Discontinued | $43.65 | $57.54 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $218.78 Typical High $229.09 | Professional | 54 · Surgery only | $162.18 | $218.78 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $43.65 Typical High $45.71 | Professional | 55 · Aftercare only | $33.11 | $43.65 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $28.84 Typical High $30.20 | Professional | 56 · Pre-op care only | $21.88 | $28.84 | $30.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $204.17 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $151.36 | $204.17 | $213.80 |
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 $109.65 Median $151.36 Typical High $208.93 | Professional | 32 · Mandated service | $109.65 | $151.36 | $208.93 |
Where Alabama sits
The same service costs 4.6 times more in Alaska than in Florida. 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· 8th of 51
$288
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.