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 $2,344.23 Median $2,344.23 Typical High $2,344.23 | Professional | None | $2,344.23 | $2,344.23 | $2,344.23 |
BCBS Alabama Setting Facility Modifier None Typical Low $16,982.44 Median $17,378.01 Typical High $17,378.01 | Facility | None | $16,982.44 | $17,378.01 | $17,378.01 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery Typical Low $1,288.25 Median $1,737.80 Typical High $2,137.96 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery | $1,288.25 | $1,737.80 | $2,137.96 |
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 $1,445.44 Median $1,698.24 Typical High $2,238.72 | Professional | None | $1,445.44 | $1,698.24 | $2,238.72 |
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 $1,023.29 Median $1,318.26 Typical High $1,905.46 | Professional | None | $1,023.29 | $1,318.26 | $1,905.46 |
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 $1,174.90 Median $1,174.90 Typical High $1,174.90 | Professional | 52 · Reduced service | $1,174.90 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | 53 · Discontinued | $467.74 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Professional | 54 · Surgery only | $1,737.80 | $1,737.80 | $1,737.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | 55 · Aftercare only | $346.74 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | 56 · Pre-op care only | $234.42 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $1,621.81 | $1,621.81 | $1,621.81 |
Where Alabama sits
The same service costs 5.0 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· 16th of 51
$2,138
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.