How much rates vary
Facilitymedian $16,982 · 10th to 90th $1,202 to $17,378Professionalmedian $1,479 · 10th to 90th $1,202 to $2,344
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 $2,398.83 | Facility | None | $776.25 | $1,258.93 | $2,398.83 |
Aetna Setting Professional Modifier None Typical Low $1,659.59 Median $2,344.23 Typical High $2,344.23 | Professional | None | $1,659.59 | $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 $1,023.29 Median $1,412.54 Typical High $1,862.09 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery | $1,023.29 | $1,412.54 | $1,862.09 |
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 $1,230.27 Median $1,479.11 Typical High $2,089.30 | Professional | None | $1,230.27 | $1,479.11 | $2,089.30 |
United Setting Facility Modifier None Typical Low $1,096.48 Median $2,344.23 Typical High $5,248.07 | Facility | None | $1,096.48 | $2,344.23 | $5,248.07 |
United Setting Professional Modifier None Typical Low $1,047.13 Median $1,318.26 Typical High $1,949.84 | Professional | None | $1,047.13 | $1,318.26 | $1,949.84 |
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 $1,778.28 Median $1,778.28 Typical High $1,778.28 | Professional | 54 · Surgery only | $1,778.28 | $1,778.28 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | 55 · Aftercare only | $354.81 | $354.81 | $354.81 |
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 $1,659.59 Median $1,659.59 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $1,659.59 | $1,659.59 | $1,659.59 |
Where Alabama sits
The same service costs 6.6 times more in Alabama than in Kentucky. 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.
Physician feeFacility fee
AL $18,462KY $2,797
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.