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 $891.25 Median $1,348.96 Typical High $2,398.83 | Facility | None | $891.25 | $1,348.96 | $2,398.83 |
Aetna Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,621.81 | $1,621.81 | $1,621.81 |
BCBS Alabama Setting Facility Modifier None Typical Low $8,317.64 Median $8,317.64 Typical High $8,317.64 | Facility | None | $8,317.64 | $8,317.64 | $8,317.64 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery Typical Low $933.25 Median $1,258.93 Typical High $1,584.89 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery | $933.25 | $1,258.93 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $6,456.54 Typical High $7,943.28 | Facility | None | $741.31 | $6,456.54 | $7,943.28 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,174.90 Typical High $1,288.25 | Professional | None | $1,000.00 | $1,174.90 | $1,288.25 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $3,801.89 Typical High $8,709.64 | Facility | None | $1,698.24 | $3,801.89 | $8,709.64 |
United Setting Professional Modifier None Typical Low $776.25 Median $977.24 Typical High $1,584.89 | Professional | None | $776.25 | $977.24 | $1,584.89 |
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 $812.83 Median $812.83 Typical High $812.83 | Professional | 52 · Reduced service | $812.83 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | 53 · Discontinued | $323.59 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | 54 · Surgery only | $1,202.26 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | 55 · Aftercare only | $239.88 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | 56 · Pre-op care only | $162.18 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,122.02 | $1,122.02 |
BCBS Alabama Setting Facility Modifier 50 · Both sides Typical Low $12,302.69 Median $12,589.25 Typical High $12,589.25 | Facility | 50 · Both sides | $12,302.69 | $12,589.25 | $12,589.25 |
Where Alabama sits
The same service costs 8.5 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· 14th of 51
$1,622
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.