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 $645.65 Median $1,230.27 Typical High $2,398.83 | Facility | None | $645.65 | $1,230.27 | $2,398.83 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $512.86 Typical High $724.44 | Professional | None | $398.11 | $512.86 | $724.44 |
BCBS Alabama Setting Facility Modifier None Typical Low $2,511.89 Median $2,570.40 Typical High $2,570.40 | Facility | None | $2,511.89 | $2,570.40 | $2,570.40 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $741.31 Typical High $1,047.13 | Facility | None | $489.78 | $741.31 | $1,047.13 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $407.38 Typical High $562.34 | Professional | None | $323.59 | $407.38 | $562.34 |
United Setting Facility Modifier None Typical Low $467.74 Median $1,000.00 Typical High $3,162.28 | Facility | None | $467.74 | $1,000.00 | $3,162.28 |
United Setting Professional Modifier None Typical Low $257.04 Median $389.05 Typical High $645.65 | Professional | None | $257.04 | $389.05 | $645.65 |
8 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 $257.04 Median $257.04 Typical High $363.08 | Professional | 52 · Reduced service | $257.04 | $257.04 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $102.33 Typical High $144.54 | Professional | 53 · Discontinued | $102.33 | $102.33 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $380.19 Typical High $549.54 | Professional | 54 · Surgery only | $380.19 | $380.19 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $77.62 Typical High $109.65 | Professional | 55 · Aftercare only | $77.62 | $77.62 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $51.29 Typical High $72.44 | Professional | 56 · Pre-op care only | $51.29 | $51.29 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $354.81 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $354.81 | $354.81 | $512.86 |
BCBS Alabama Setting Facility Modifier 50 · Both sides Typical Low $3,801.89 Median $3,801.89 Typical High $3,801.89 | Facility | 50 · Both sides | $3,801.89 | $3,801.89 | $3,801.89 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 Typical Low $234.42 Median $323.59 Typical High $436.52 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 | $234.42 | $323.59 | $436.52 |
Where Alabama sits
The same service costs 4.9 times more in Alaska than in Utah. 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· 25th of 51
$513
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.