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 $2,630.27 | Facility | None | $776.25 | $1,258.93 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $5,623.41 Median $5,623.41 Typical High $5,623.41 | Professional | None | $5,623.41 | $5,623.41 | $5,623.41 |
BCBS Alabama Setting Facility Modifier None Typical Low $17,782.79 Median $18,197.01 Typical High $18,197.01 | Facility | None | $17,782.79 | $18,197.01 | $18,197.01 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery Typical Low $3,235.94 Median $4,466.84 Typical High $5,248.07 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery | $3,235.94 | $4,466.84 | $5,248.07 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $549.54 Typical High $1,202.26 | Facility | None | $446.68 | $549.54 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $3,715.35 Median $4,365.16 Typical High $5,623.41 | Professional | None | $3,715.35 | $4,365.16 | $5,623.41 |
United Setting Facility Modifier None Typical Low $371.54 Median $954.99 Typical High $3,801.89 | Facility | None | $371.54 | $954.99 | $3,801.89 |
United Setting Professional Modifier None Typical Low $2,511.89 Median $3,235.94 Typical High $4,677.35 | Professional | None | $2,511.89 | $3,235.94 | $4,677.35 |
6 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 $2,818.38 Median $2,818.38 Typical High $2,818.38 | Professional | 52 · Reduced service | $2,818.38 | $2,818.38 | $2,818.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | 53 · Discontinued | $1,148.15 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $4,265.80 Median $4,265.80 Typical High $4,265.80 | Professional | 54 · Surgery only | $4,265.80 | $4,265.80 | $4,265.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | 55 · Aftercare only | $851.14 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | 56 · Pre-op care only | $562.34 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,981.07 Median $3,981.07 Typical High $3,981.07 | Professional | 78 · Unplanned return to OR | $3,981.07 | $3,981.07 | $3,981.07 |
Where Alabama sits
The same service costs 6.3 times more in Alaska than in Arkansas. 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· 21st of 51
$4,365
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.