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 $6,025.60 Median $6,025.60 Typical High $6,025.60 | Professional | None | $6,025.60 | $6,025.60 | $6,025.60 |
BCBS Alabama Setting Facility Modifier None Typical Low $7,585.78 Median $7,585.78 Typical High $7,585.78 | Facility | None | $7,585.78 | $7,585.78 | $7,585.78 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery Typical Low $3,019.95 Median $4,168.69 Typical High $5,370.32 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery | $3,019.95 | $4,168.69 | $5,370.32 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $4,466.84 Typical High $5,495.41 | Facility | None | $549.54 | $4,466.84 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $3,388.44 Median $3,801.89 Typical High $4,466.84 | Professional | None | $3,388.44 | $3,801.89 | $4,466.84 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $3,311.31 Typical High $6,456.54 | Facility | None | $1,288.25 | $3,311.31 | $6,456.54 |
United Setting Professional Modifier None Typical Low $2,951.21 Median $3,715.35 Typical High $6,025.60 | Professional | None | $2,951.21 | $3,715.35 | $6,025.60 |
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 $3,019.95 Median $3,019.95 Typical High $3,019.95 | Professional | 52 · Reduced service | $3,019.95 | $3,019.95 | $3,019.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | 53 · Discontinued | $1,202.26 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $4,570.88 Median $4,570.88 Typical High $4,570.88 | Professional | 54 · Surgery only | $4,570.88 | $4,570.88 | $4,570.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $912.01 Median $912.01 Typical High $912.01 | Professional | 55 · Aftercare only | $912.01 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | 56 · Pre-op care only | $602.56 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $4,265.80 Median $4,265.80 Typical High $4,265.80 | Professional | 78 · Unplanned return to OR | $4,265.80 | $4,265.80 | $4,265.80 |
BCBS Alabama Setting Facility Modifier 50 · Both sides Typical Low $11,481.54 Median $11,481.54 Typical High $11,481.54 | Facility | 50 · Both sides | $11,481.54 | $11,481.54 | $11,481.54 |
Where Alabama sits
The same service costs 20.4 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· 30th of 51
$4,467
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.