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 $5,248.07 Median $5,248.07 Typical High $5,248.07 | Professional | None | $5,248.07 | $5,248.07 | $5,248.07 |
BCBS Alabama Setting Facility Modifier None Typical Low $8,317.64 Median $8,317.64 Typical High $8,317.64 | Facility | None | $8,317.64 | $8,317.64 | $8,317.64 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery Typical Low $2,951.21 Median $4,073.80 Typical High $5,011.87 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery | $2,951.21 | $4,073.80 | $5,011.87 |
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 $3,311.31 Median $3,890.45 Typical High $4,466.84 | Professional | None | $3,311.31 | $3,890.45 | $4,466.84 |
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 $2,570.40 Median $3,162.28 Typical High $5,370.32 | Professional | None | $2,570.40 | $3,162.28 | $5,370.32 |
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 $2,630.27 Median $2,630.27 Typical High $2,630.27 | Professional | 52 · Reduced service | $2,630.27 | $2,630.27 | $2,630.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Professional | 53 · Discontinued | $1,047.13 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,890.45 Median $3,890.45 Typical High $3,890.45 | Professional | 54 · Surgery only | $3,890.45 | $3,890.45 | $3,890.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $776.25 Median $776.25 Typical High $776.25 | Professional | 55 · Aftercare only | $776.25 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | 56 · Pre-op care only | $524.81 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,630.78 Median $3,630.78 Typical High $3,630.78 | Professional | 78 · Unplanned return to OR | $3,630.78 | $3,630.78 | $3,630.78 |
BCBS Alabama Setting Facility Modifier 50 · Both sides Typical Low $12,302.69 Median $12,589.25 Typical High $12,589.25 | Facility | 50 · Both sides | $12,302.69 | $12,589.25 | $12,589.25 |
Where Alabama sits
The same service costs 20.4 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· 17th of 51
$4,898
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.