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 $562.34 Median $954.99 Typical High $2,398.83 | Facility | None | $562.34 | $954.99 | $2,398.83 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $407.38 | Professional | None | $263.03 | $263.03 | $407.38 |
BCBS Alabama Setting Facility Modifier None Typical Low $2,511.89 Median $2,570.40 Typical High $2,570.40 | Facility | None | $2,511.89 | $2,570.40 | $2,570.40 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $218.78 Typical High $501.19 | Facility | None | $173.78 | $218.78 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $223.87 Typical High $295.12 | Professional | None | $165.96 | $223.87 | $295.12 |
United Setting Facility Modifier None Typical Low $467.74 Median $1,000.00 Typical High $3,162.28 | Facility | None | $467.74 | $1,000.00 | $3,162.28 |
United Setting Professional Modifier None Typical Low $134.90 Median $208.93 Typical High $354.81 | Professional | None | $134.90 | $208.93 | $354.81 |
8 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 $131.83 Median $131.83 Typical High $204.17 | Professional | 52 · Reduced service | $131.83 | $131.83 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $52.48 Typical High $81.28 | Professional | 53 · Discontinued | $52.48 | $52.48 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $194.98 Typical High $302.00 | Professional | 54 · Surgery only | $194.98 | $194.98 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $39.81 Typical High $60.26 | Professional | 55 · Aftercare only | $39.81 | $39.81 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $26.30 Typical High $40.74 | Professional | 56 · Pre-op care only | $26.30 | $26.30 | $40.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $181.97 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $181.97 | $181.97 | $281.84 |
BCBS Alabama Setting Facility Modifier 50 · Both sides Typical Low $3,801.89 Median $3,801.89 Typical High $3,801.89 | Facility | 50 · Both sides | $3,801.89 | $3,801.89 | $3,801.89 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 Typical Low $114.82 Median $158.49 Typical High $223.87 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 | $114.82 | $158.49 | $223.87 |
Where Alabama sits
The same service costs 3.7 times more in Alaska than in Utah. 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· 28th of 51
$263
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.