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 $2,454.71 Median $2,454.71 Typical High $2,454.71 | Professional | None | $2,454.71 | $2,454.71 | $2,454.71 |
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 $1,174.90 Median $1,584.89 Typical High $2,089.30 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery | $1,174.90 | $1,584.89 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $1,621.81 Typical High $1,949.84 | Facility | None | $741.31 | $1,621.81 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $1,479.11 Median $1,778.28 Typical High $1,862.09 | Professional | None | $1,479.11 | $1,778.28 | $1,862.09 |
United Setting Facility Modifier None Typical Low $467.74 Median $1,000.00 Typical High $3,235.94 | Facility | None | $467.74 | $1,000.00 | $3,235.94 |
United Setting Professional Modifier None Typical Low $1,174.90 Median $1,412.54 Typical High $2,290.87 | Professional | None | $1,174.90 | $1,412.54 | $2,290.87 |
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 $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | 52 · Reduced service | $1,230.27 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | 53 · Discontinued | $489.78 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Professional | 54 · Surgery only | $1,862.09 | $1,862.09 | $1,862.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | 55 · Aftercare only | $371.54 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | 56 · Pre-op care only | $245.47 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $1,737.80 | $1,737.80 | $1,737.80 |
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 15.8 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· 31st of 51
$1,778
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.