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 $812.83 Median $1,230.27 Typical High $1,230.27 | Professional | None | $812.83 | $1,230.27 | $1,230.27 |
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 $794.33 Median $794.33 Typical High $794.33 | Professional | None | $794.33 | $794.33 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,737.80 Typical High $2,041.74 | Facility | None | $645.65 | $1,737.80 | $2,041.74 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $676.08 Typical High $851.14 | Professional | None | $575.44 | $676.08 | $851.14 |
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 $524.81 Median $616.60 Typical High $831.76 | Professional | None | $524.81 | $616.60 | $831.76 |
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 $446.68 Median $616.60 Typical High $616.60 | Professional | 52 · Reduced service | $446.68 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $251.19 Typical High $251.19 | Professional | 53 · Discontinued | $177.83 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $933.25 Typical High $933.25 | Professional | 54 · Surgery only | $660.69 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $186.21 Typical High $186.21 | Professional | 55 · Aftercare only | $134.90 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $123.03 Typical High $123.03 | Professional | 56 · Pre-op care only | $89.13 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $870.96 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $616.60 | $870.96 | $870.96 |
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 $575.44 Median $794.33 Typical High $954.99 | Professional | 32 · Mandated service | $575.44 | $794.33 | $954.99 |
Where Alabama sits
The same service costs 8.5 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· 12th of 51
$1,230
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.