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 $794.33 Median $1,513.56 Typical High $2,398.83 | Facility | None | $794.33 | $1,513.56 | $2,398.83 |
Aetna Setting Professional Modifier None Typical Low $4,265.80 Median $4,265.80 Typical High $4,265.80 | Professional | None | $4,265.80 | $4,265.80 | $4,265.80 |
BCBS Alabama Setting Facility Modifier None Typical Low $5,011.87 Median $5,011.87 Typical High $5,011.87 | Facility | None | $5,011.87 | $5,011.87 | $5,011.87 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery Typical Low $2,511.89 Median $3,388.44 Typical High $4,265.80 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery | $2,511.89 | $3,388.44 | $4,265.80 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $4,466.84 Typical High $5,495.41 | Facility | None | $512.86 | $4,466.84 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $2,691.53 Median $3,162.28 Typical High $3,548.13 | Professional | None | $2,691.53 | $3,162.28 | $3,548.13 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $3,801.89 Typical High $8,511.38 | Facility | None | $1,513.56 | $3,801.89 | $8,511.38 |
United Setting Professional Modifier None Typical Low $2,089.30 Median $2,570.40 Typical High $4,265.80 | Professional | None | $2,089.30 | $2,570.40 | $4,265.80 |
6 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 $2,089.30 Median $2,089.30 Typical High $2,089.30 | Professional | 52 · Reduced service | $2,089.30 | $2,089.30 | $2,089.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | 53 · Discontinued | $851.14 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,162.28 Median $3,162.28 Typical High $3,162.28 | Professional | 54 · Surgery only | $3,162.28 | $3,162.28 | $3,162.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | 55 · Aftercare only | $630.96 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $426.58 Median $426.58 Typical High $426.58 | Professional | 56 · Pre-op care only | $426.58 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,951.21 Median $2,951.21 Typical High $2,951.21 | Professional | 78 · Unplanned return to OR | $2,951.21 | $2,951.21 | $2,951.21 |
Where Alabama sits
The same service costs 8.7 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· 20th of 51
$3,802
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.