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 $954.99 Median $1,584.89 Typical High $2,570.40 | Facility | None | $954.99 | $1,584.89 | $2,570.40 |
Aetna Setting Professional Modifier None Typical Low $3,981.07 Median $3,981.07 Typical High $3,981.07 | Professional | None | $3,981.07 | $3,981.07 | $3,981.07 |
BCBS Alabama Setting Facility Modifier None Typical Low $19,054.61 Median $19,054.61 Typical High $19,054.61 | Facility | None | $19,054.61 | $19,054.61 | $19,054.61 |
BCBS Alabama Setting Professional Modifier 21 Typical Low $2,454.71 Median $3,388.44 Typical High $4,073.80 | Professional | 21 | $2,454.71 | $3,388.44 | $4,073.80 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $8,709.64 Typical High $10,964.78 | Facility | None | $512.86 | $8,709.64 | $10,964.78 |
Cigna Setting Professional Modifier None Typical Low $2,754.23 Median $3,235.94 Typical High $3,467.37 | Professional | None | $2,754.23 | $3,235.94 | $3,467.37 |
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 $1,949.84 Median $2,398.83 Typical High $3,981.07 | Professional | None | $1,949.84 | $2,398.83 | $3,981.07 |
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 $1,995.26 Median $1,995.26 Typical High $1,995.26 | Professional | 52 · Reduced service | $1,995.26 | $1,995.26 | $1,995.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | 53 · Discontinued | $794.33 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,951.21 Median $2,951.21 Typical High $2,951.21 | Professional | 54 · Surgery only | $2,951.21 | $2,951.21 | $2,951.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | 55 · Aftercare only | $588.84 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | 56 · Pre-op care only | $398.11 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,754.23 Median $2,754.23 Typical High $2,754.23 | Professional | 78 · Unplanned return to OR | $2,754.23 | $2,754.23 | $2,754.23 |
Where Alabama sits
The same service costs 25.7 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· 16th of 51
$3,981
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.