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 $1,862.09 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,862.09 | $1,862.09 | $1,862.09 |
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 $1,122.02 Median $1,548.82 Typical High $1,905.46 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery | $1,122.02 | $1,548.82 | $1,905.46 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $4,897.79 Typical High $6,025.60 | Facility | None | $645.65 | $4,897.79 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,380.38 Typical High $1,548.82 | Professional | None | $1,174.90 | $1,380.38 | $1,548.82 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $3,801.89 Typical High $8,511.38 | Facility | None | $1,698.24 | $3,801.89 | $8,511.38 |
United Setting Professional Modifier None Typical Low $912.01 Median $1,122.02 Typical High $1,949.84 | Professional | None | $912.01 | $1,122.02 | $1,949.84 |
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 $933.25 Median $933.25 Typical High $933.25 | Professional | 52 · Reduced service | $933.25 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | 53 · Discontinued | $371.54 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,412.54 | $1,412.54 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | 55 · Aftercare only | $281.84 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | 56 · Pre-op care only | $186.21 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $1,318.26 | $1,318.26 | $1,318.26 |
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 8.3 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· 19th of 51
$1,862
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.