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 $489.78 Median $933.25 Typical High $1,862.09 | Facility | None | $489.78 | $933.25 | $1,862.09 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $177.83 Typical High $257.04 | Professional | None | $169.82 | $177.83 | $257.04 |
BCBS Alabama Setting Facility Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Facility | None | $162.18 | $162.18 | $162.18 |
BCBS Alabama Setting Professional Modifier 32 · Mandated service Typical Low $131.83 Median $177.83 Typical High $269.15 | Professional | 32 · Mandated service | $131.83 | $177.83 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $138.04 Typical High $446.68 | Facility | None | $50.12 | $138.04 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $169.82 Typical High $257.04 | Professional | None | $114.82 | $169.82 | $257.04 |
United Setting Facility Modifier None Typical Low $316.23 Median $645.65 Typical High $2,511.89 | Facility | None | $316.23 | $645.65 | $2,511.89 |
United Setting Professional Modifier None Typical Low $100.00 Median $162.18 Typical High $269.15 | Professional | None | $100.00 | $162.18 | $269.15 |
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 $89.13 Median $89.13 Typical High $128.82 | Professional | 52 · Reduced service | $89.13 | $89.13 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $35.48 Typical High $51.29 | Professional | 53 · Discontinued | $35.48 | $35.48 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $134.90 Typical High $194.98 | Professional | 54 · Surgery only | $134.90 | $134.90 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $26.92 Typical High $38.90 | Professional | 55 · Aftercare only | $26.92 | $26.92 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $17.78 Typical High $25.70 | Professional | 56 · Pre-op care only | $17.78 | $17.78 | $25.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $125.89 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $125.89 | $125.89 | $181.97 |
BCBS Alabama Setting Facility Modifier 50 · Both sides Typical Low $239.88 Median $245.47 Typical High $245.47 | Facility | 50 · Both sides | $239.88 | $245.47 | $245.47 |
Where Alabama sits
The same service costs 4.1 times more in Alaska than in Kentucky. 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· 42nd of 51
$178
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.