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 $501.19 Median $602.56 Typical High $831.76 | Professional | None | $501.19 | $602.56 | $831.76 |
BCBS Alabama Setting Facility Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $3,162.28 | Facility | None | $3,162.28 | $3,162.28 | $3,162.28 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $776.25 Typical High $1,096.48 | Facility | None | $645.65 | $776.25 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $575.44 Typical High $724.44 | Professional | None | $446.68 | $575.44 | $724.44 |
United Setting Facility Modifier None Typical Low $309.03 Median $616.60 Typical High $2,511.89 | Facility | None | $309.03 | $616.60 | $2,511.89 |
United Setting Professional Modifier None Typical Low $309.03 Median $436.52 Typical High $741.31 | Professional | None | $309.03 | $436.52 | $741.31 |
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 $302.00 Median $302.00 Typical High $416.87 | Professional | 52 · Reduced service | $302.00 | $302.00 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $120.23 Typical High $165.96 | Professional | 53 · Discontinued | $120.23 | $120.23 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $446.68 Typical High $616.60 | Professional | 54 · Surgery only | $446.68 | $446.68 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $91.20 Typical High $123.03 | Professional | 55 · Aftercare only | $91.20 | $91.20 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $60.26 Typical High $83.18 | Professional | 56 · Pre-op care only | $60.26 | $60.26 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $416.87 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $416.87 | $416.87 | $575.44 |
BCBS Alabama Setting Facility Modifier 50 · Both sides Typical Low $4,677.35 Median $4,786.30 Typical High $4,786.30 | Facility | 50 · Both sides | $4,677.35 | $4,786.30 | $4,786.30 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 Typical Low $489.78 Median $602.56 Typical High $707.95 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 | $489.78 | $602.56 | $707.95 |
Where Alabama sits
The same service costs 4.8 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· 22nd of 51
$603
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.