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 $2,630.27 | Facility | None | $776.25 | $1,258.93 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $151.36 Typical High $181.97 | Professional | None | $97.72 | $151.36 | $181.97 |
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 $64.57 Median $89.13 Typical High $147.91 | Professional | None | $64.57 | $89.13 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $102.33 Typical High $512.86 | Facility | None | $50.12 | $102.33 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $109.65 Typical High $147.91 | Professional | None | $81.28 | $109.65 | $147.91 |
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 $67.61 Median $87.10 Typical High $125.89 | Professional | None | $67.61 | $87.10 | $125.89 |
7 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 $63.10 Median $75.86 Typical High $91.20 | Professional | 52 · Reduced service | $63.10 | $75.86 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $30.20 Typical High $36.31 | Professional | 53 · Discontinued | $25.70 | $30.20 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $114.82 Typical High $134.90 | Professional | 54 · Surgery only | $95.50 | $114.82 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $22.91 Typical High $26.92 | Professional | 55 · Aftercare only | $19.05 | $22.91 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $15.14 Typical High $18.20 | Professional | 56 · Pre-op care only | $12.59 | $15.14 | $18.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $107.15 Typical High $125.89 | Professional | 78 · Unplanned return to OR | $89.13 | $107.15 | $125.89 |
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 |
Where Alabama sits
The same service costs 4.2 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· 22nd of 51
$126
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.