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 $1,698.24 Median $2,630.27 Typical High $2,630.27 | Professional | None | $1,698.24 | $2,630.27 | $2,630.27 |
BCBS Alabama Setting Facility Modifier None Typical Low $8,128.31 Median $8,128.31 Typical High $8,128.31 | Facility | None | $8,128.31 | $8,128.31 | $8,128.31 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery Typical Low $1,819.70 Median $2,454.71 Typical High $2,691.53 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery | $1,819.70 | $2,454.71 | $2,691.53 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $3,548.13 Typical High $4,365.16 | Facility | None | $549.54 | $3,548.13 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $1,659.59 Median $1,949.84 Typical High $2,187.76 | Professional | None | $1,659.59 | $1,949.84 | $2,187.76 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $4,466.84 Typical High $8,511.38 | Facility | None | $1,698.24 | $4,466.84 | $8,511.38 |
United Setting Professional Modifier None Typical Low $1,288.25 Median $1,584.89 Typical High $2,630.27 | Professional | None | $1,288.25 | $1,584.89 | $2,630.27 |
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 $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | 52 · Reduced service | $1,318.26 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | 53 · Discontinued | $524.81 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Professional | 54 · Surgery only | $1,995.26 | $1,995.26 | $1,995.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | 55 · Aftercare only | $398.11 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | 56 · Pre-op care only | $263.03 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $1,862.09 | $1,862.09 | $1,862.09 |
BCBS Alabama Setting Facility Modifier 50 · Both sides Typical Low $12,302.69 Median $12,302.69 Typical High $12,302.69 | Facility | 50 · Both sides | $12,302.69 | $12,302.69 | $12,302.69 |
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· 20th of 51
$2,455
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.