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 $4,365.16 Median $4,365.16 Typical High $4,365.16 | Professional | None | $4,365.16 | $4,365.16 | $4,365.16 |
BCBS Alabama Setting Facility Modifier None Typical Low $14,125.38 Median $14,125.38 Typical High $14,125.38 | Facility | None | $14,125.38 | $14,125.38 | $14,125.38 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery Typical Low $2,290.87 Median $3,162.28 Typical High $3,981.07 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery | $2,290.87 | $3,162.28 | $3,981.07 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $13,182.57 Typical High $16,595.87 | Facility | None | $512.86 | $13,182.57 | $16,595.87 |
Cigna Setting Professional Modifier None Typical Low $2,691.53 Median $3,235.94 Typical High $3,715.35 | Professional | None | $2,691.53 | $3,235.94 | $3,715.35 |
United Setting Facility Modifier None Typical Low $1,584.89 Median $5,128.61 Typical High $11,481.54 | Facility | None | $1,584.89 | $5,128.61 | $11,481.54 |
United Setting Professional Modifier None Typical Low $2,137.96 Median $2,630.27 Typical High $4,265.80 | Professional | None | $2,137.96 | $2,630.27 | $4,265.80 |
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 $2,187.76 Median $2,187.76 Typical High $2,187.76 | Professional | 52 · Reduced service | $2,187.76 | $2,187.76 | $2,187.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $870.96 Median $870.96 Typical High $870.96 | Professional | 53 · Discontinued | $870.96 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,311.31 Median $3,311.31 Typical High $3,311.31 | Professional | 54 · Surgery only | $3,311.31 | $3,311.31 | $3,311.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | 55 · Aftercare only | $660.69 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | 56 · Pre-op care only | $436.52 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,090.30 Median $3,090.30 Typical High $3,090.30 | Professional | 78 · Unplanned return to OR | $3,090.30 | $3,090.30 | $3,090.30 |
BCBS Alabama Setting Facility Modifier 50 · Both sides Typical Low $20,892.96 Median $21,379.62 Typical High $21,379.62 | Facility | 50 · Both sides | $20,892.96 | $21,379.62 | $21,379.62 |
Where Alabama sits
The same service costs 20.0 times more in Alaska than in Texas. 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· 16th of 51
$4,169
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.