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 $2,884.03 Median $2,884.03 Typical High $2,884.03 | Professional | None | $2,884.03 | $2,884.03 | $2,884.03 |
BCBS Alabama Setting Facility Modifier None Typical Low $3,162.28 Median $3,235.94 Typical High $3,235.94 | Facility | None | $3,162.28 | $3,235.94 | $3,235.94 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery Typical Low $1,737.80 Median $2,398.83 Typical High $2,951.21 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery | $1,737.80 | $2,398.83 | $2,951.21 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $870.96 Typical High $1,230.27 | Facility | None | $512.86 | $870.96 | $1,230.27 |
Cigna Setting Professional Modifier None Typical Low $1,862.09 Median $2,187.76 Typical High $2,511.89 | Professional | None | $1,862.09 | $2,187.76 | $2,511.89 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $3,467.37 Typical High $7,413.10 | Facility | None | $1,513.56 | $3,467.37 | $7,413.10 |
United Setting Professional Modifier None Typical Low $1,412.54 Median $1,778.28 Typical High $3,162.28 | Professional | None | $1,412.54 | $1,778.28 | $3,162.28 |
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 $1,445.44 Median $1,445.44 Typical High $1,445.44 | Professional | 52 · Reduced service | $1,445.44 | $1,445.44 | $1,445.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | 53 · Discontinued | $588.84 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,187.76 Median $2,187.76 Typical High $2,187.76 | Professional | 54 · Surgery only | $2,187.76 | $2,187.76 | $2,187.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | 55 · Aftercare only | $436.52 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | 56 · Pre-op care only | $288.40 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,041.74 Median $2,041.74 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $2,041.74 | $2,041.74 | $2,041.74 |
BCBS Alabama Setting Facility Modifier 50 · Both sides Typical Low $4,786.30 Median $4,786.30 Typical High $4,786.30 | Facility | 50 · Both sides | $4,786.30 | $4,786.30 | $4,786.30 |
Where Alabama sits
The same service costs 18.6 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· 21st of 51
$2,692
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.