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 $2,187.76 Median $2,187.76 Typical High $2,187.76 | Professional | None | $2,187.76 | $2,187.76 | $2,187.76 |
BCBS Alabama Setting Facility Modifier None Typical Low $7,079.46 Median $7,244.36 Typical High $7,244.36 | Facility | None | $7,079.46 | $7,244.36 | $7,244.36 |
BCBS Alabama Setting Facility Modifier 50 · Both sides Typical Low $10,715.19 Median $10,715.19 Typical High $10,715.19 | Facility | 50 · Both sides | $10,715.19 | $10,715.19 | $10,715.19 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery Typical Low $1,318.26 Median $1,778.28 Typical High $1,995.26 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery | $1,318.26 | $1,778.28 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $1,380.38 Median $3,162.28 Typical High $4,466.84 | Facility | None | $1,380.38 | $3,162.28 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $1,445.44 Median $1,698.24 Typical High $2,137.96 | Professional | None | $1,445.44 | $1,698.24 | $2,137.96 |
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 $977.24 Median $1,348.96 Typical High $1,819.70 | Professional | None | $977.24 | $1,348.96 | $1,819.70 |
2 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 54 · Surgery only Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Professional | 54 · Surgery only | $1,621.81 | $1,621.81 | $1,621.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $1,513.56 | $1,513.56 | $1,513.56 |
Where Alabama sits
The same service costs 5.4 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· 11th 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.