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 $1,819.70 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,819.70 | $1,819.70 | $1,819.70 |
BCBS Alabama Setting Facility Modifier None Typical Low $5,370.32 Median $5,370.32 Typical High $5,370.32 | Facility | None | $5,370.32 | $5,370.32 | $5,370.32 |
BCBS Alabama Setting Facility Modifier 50 · Both sides Typical Low $7,943.28 Median $8,128.31 Typical High $8,128.31 | Facility | 50 · Both sides | $7,943.28 | $8,128.31 | $8,128.31 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery Typical Low $1,122.02 Median $1,513.56 Typical High $1,698.24 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery | $1,122.02 | $1,513.56 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $3,019.95 Typical High $3,801.89 | Facility | None | $549.54 | $3,019.95 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,584.89 Typical High $1,737.80 | Professional | None | $1,288.25 | $1,584.89 | $1,737.80 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $3,801.89 Typical High $8,317.64 | Facility | None | $1,698.24 | $3,801.89 | $8,317.64 |
United Setting Professional Modifier None Typical Low $794.33 Median $1,122.02 Typical High $1,548.82 | Professional | None | $794.33 | $1,122.02 | $1,548.82 |
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 $891.25 Median $891.25 Typical High $891.25 | Professional | 52 · Reduced service | $891.25 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | 53 · Discontinued | $363.08 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,348.96 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | 55 · Aftercare only | $269.15 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | 56 · Pre-op care only | $181.97 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $1,258.93 | $1,258.93 | $1,258.93 |
Where Alabama sits
The same service costs 5.1 times more in Wisconsin 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· 7th of 51
$2,630
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.