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 $2,630.27 | Facility | None | $794.33 | $1,513.56 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $4,570.88 Median $4,570.88 Typical High $4,570.88 | Professional | None | $4,570.88 | $4,570.88 | $4,570.88 |
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 $2,691.53 Median $3,715.35 Typical High $4,570.88 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery | $2,691.53 | $3,715.35 | $4,570.88 |
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 $2,884.03 Median $3,388.44 Typical High $3,890.45 | Professional | None | $2,884.03 | $3,388.44 | $3,890.45 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $3,311.31 Typical High $6,456.54 | Facility | None | $1,288.25 | $3,311.31 | $6,456.54 |
United Setting Professional Modifier None Typical Low $2,238.72 Median $2,754.23 Typical High $4,570.88 | Professional | None | $2,238.72 | $2,754.23 | $4,570.88 |
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 $2,290.87 Median $2,290.87 Typical High $2,290.87 | Professional | 52 · Reduced service | $2,290.87 | $2,290.87 | $2,290.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $912.01 Median $912.01 Typical High $912.01 | Professional | 53 · Discontinued | $912.01 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,388.44 Median $3,388.44 Typical High $3,388.44 | Professional | 54 · Surgery only | $3,388.44 | $3,388.44 | $3,388.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | 55 · Aftercare only | $676.08 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | 56 · Pre-op care only | $457.09 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,162.28 Median $3,162.28 Typical High $3,162.28 | Professional | 78 · Unplanned return to OR | $3,162.28 | $3,162.28 | $3,162.28 |
Where Alabama sits
The same service costs 19.1 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· 22nd of 51
$3,890
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.