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 $8,511.38 Median $8,511.38 Typical High $8,511.38 | Professional | None | $8,511.38 | $8,511.38 | $8,511.38 |
BCBS Alabama Setting Facility Modifier None Typical Low $7,244.36 Median $7,244.36 Typical High $7,244.36 | Facility | None | $7,244.36 | $7,244.36 | $7,244.36 |
BCBS Alabama Setting Professional Modifier 21 Typical Low $6,309.57 Median $7,244.36 Typical High $8,912.51 | Professional | 21 | $6,309.57 | $7,244.36 | $8,912.51 |
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 $3,311.31 Median $4,786.30 Typical High $7,079.46 | Professional | None | $3,311.31 | $4,786.30 | $7,079.46 |
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 $4,265.80 Median $4,265.80 Typical High $4,265.80 | Professional | 52 · Reduced service | $4,265.80 | $4,265.80 | $4,265.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Professional | 53 · Discontinued | $1,698.24 | $1,698.24 | $1,698.24 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $6,456.54 Median $6,456.54 Typical High $6,456.54 | Professional | 54 · Surgery only | $6,456.54 | $6,456.54 | $6,456.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | 55 · Aftercare only | $1,288.25 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | 56 · Pre-op care only | $851.14 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $6,025.60 Median $6,025.60 Typical High $6,025.60 | Professional | 78 · Unplanned return to OR | $6,025.60 | $6,025.60 | $6,025.60 |
Where Alabama sits
The same service costs 9.1 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· 15th of 51
$7,244
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.