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 $776.25 Median $1,258.93 Typical High $2,398.83 | Facility | None | $776.25 | $1,258.93 | $2,398.83 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Professional | None | $1,174.90 | $1,174.90 | $1,174.90 |
BCBS Alabama Setting Facility Modifier None Typical Low $3,162.28 Median $3,235.94 Typical High $3,235.94 | Facility | None | $3,162.28 | $3,235.94 | $3,235.94 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery Typical Low $512.86 Median $707.95 Typical High $977.24 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery | $512.86 | $707.95 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $1,548.82 Typical High $1,949.84 | Facility | None | $549.54 | $1,548.82 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $851.14 Typical High $870.96 | Professional | None | $630.96 | $851.14 | $870.96 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $3,311.31 Typical High $6,309.57 | Facility | None | $1,288.25 | $3,311.31 | $6,309.57 |
United Setting Professional Modifier None Typical Low $575.44 Median $707.95 Typical High $1,122.02 | Professional | None | $575.44 | $707.95 | $1,122.02 |
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 $588.84 Median $588.84 Typical High $588.84 | Professional | 52 · Reduced service | $588.84 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | 53 · Discontinued | $239.88 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $891.25 Typical High $891.25 | Professional | 54 · Surgery only | $891.25 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | 55 · Aftercare only | $177.83 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | 56 · Pre-op care only | $117.49 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $831.76 | $831.76 | $831.76 |
BCBS Alabama Setting Facility Modifier 50 · Both sides Typical Low $4,786.30 Median $4,786.30 Typical High $4,786.30 | Facility | 50 · Both sides | $4,786.30 | $4,786.30 | $4,786.30 |
Where Alabama sits
The same service costs 7.8 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
$1,175
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.