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 $1,122.02 Median $1,122.02 Typical High $1,122.02 | Professional | None | $1,122.02 | $1,122.02 | $1,122.02 |
BCBS Alabama Setting Facility Modifier None Typical Low $5,011.87 Median $5,011.87 Typical High $5,011.87 | Facility | None | $5,011.87 | $5,011.87 | $5,011.87 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery Typical Low $588.84 Median $794.33 Typical High $1,000.00 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery | $588.84 | $794.33 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $2,041.74 Typical High $2,511.89 | Facility | None | $549.54 | $2,041.74 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $812.83 Typical High $851.14 | Professional | None | $691.83 | $812.83 | $851.14 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,737.80 Typical High $4,168.69 | Facility | None | $758.58 | $1,737.80 | $4,168.69 |
United Setting Professional Modifier None Typical Low $537.03 Median $645.65 Typical High $1,096.48 | Professional | None | $537.03 | $645.65 | $1,096.48 |
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 $562.34 Median $562.34 Typical High $562.34 | Professional | 52 · Reduced service | $562.34 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | 53 · Discontinued | $223.87 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | 54 · Surgery only | $851.14 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | 55 · Aftercare only | $169.82 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | 56 · Pre-op care only | $112.20 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $794.33 | $794.33 | $794.33 |
BCBS Alabama Setting Facility Modifier 50 · Both sides Typical Low $7,413.10 Median $7,585.78 Typical High $7,585.78 | Facility | 50 · Both sides | $7,413.10 | $7,585.78 | $7,585.78 |
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· 18th of 51
$1,096
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.