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 $128.82 Median $223.87 Typical High $275.42 | Professional | None | $128.82 | $223.87 | $275.42 |
Ambetter Setting Professional Modifier None Typical Low $58.88 Median $120.23 Typical High $169.82 | Professional | None | $58.88 | $120.23 | $169.82 |
BCBS Alabama Setting Facility Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Facility | None | $457.09 | $457.09 | $457.09 |
BCBS Alabama Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | None | $141.25 | $141.25 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $100.00 Typical High $446.68 | Facility | None | $50.12 | $100.00 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $128.82 Typical High $186.21 | Professional | None | $117.49 | $128.82 | $186.21 |
United Setting Facility Modifier None Typical Low $100.00 Median $371.54 Typical High $1,380.38 | Facility | None | $100.00 | $371.54 | $1,380.38 |
United Setting Professional Modifier None Typical Low $102.33 Median $131.83 Typical High $173.78 | Professional | None | $102.33 | $131.83 | $173.78 |
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 $95.50 Median $112.20 Typical High $138.04 | Professional | 52 · Reduced service | $95.50 | $112.20 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $44.67 Typical High $54.95 | Professional | 53 · Discontinued | $38.02 | $44.67 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $169.82 Typical High $204.17 | Professional | 54 · Surgery only | $141.25 | $169.82 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $33.88 Typical High $40.74 | Professional | 55 · Aftercare only | $28.84 | $33.88 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $22.39 Typical High $27.54 | Professional | 56 · Pre-op care only | $19.05 | $22.39 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $158.49 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $131.83 | $158.49 | $190.55 |
BCBS Alabama Setting Facility Modifier 50 · Both sides Typical Low $691.83 Median $691.83 Typical High $691.83 | Facility | 50 · Both sides | $691.83 | $691.83 | $691.83 |
BCBS Alabama Setting Professional Modifier 32 · Mandated service Typical Low $102.33 Median $141.25 Typical High $194.98 | Professional | 32 · Mandated service | $102.33 | $141.25 | $194.98 |
Where Alabama sits
The same service costs 4.1 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· 15th of 51
$195
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.