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 $645.65 Median $1,230.27 Typical High $2,398.83 | Facility | None | $645.65 | $1,230.27 | $2,398.83 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $758.58 Typical High $758.58 | Professional | None | $602.56 | $758.58 | $758.58 |
BCBS Alabama Setting Facility Modifier None Typical Low $4,168.69 Median $4,265.80 Typical High $4,265.80 | Facility | None | $4,168.69 | $4,265.80 | $4,265.80 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery Typical Low $426.58 Median $588.84 Typical High $758.58 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery | $426.58 | $588.84 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $1,174.90 Typical High $1,479.11 | Facility | None | $489.78 | $1,174.90 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $501.19 Typical High $707.95 | Professional | None | $416.87 | $501.19 | $707.95 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,737.80 Typical High $4,168.69 | Facility | None | $758.58 | $1,737.80 | $4,168.69 |
United Setting Professional Modifier None Typical Low $389.05 Median $467.74 Typical High $691.83 | Professional | None | $389.05 | $467.74 | $691.83 |
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 $380.19 Median $380.19 Typical High $380.19 | Professional | 52 · Reduced service | $380.19 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | 53 · Discontinued | $151.36 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $575.44 Typical High $575.44 | Professional | 54 · Surgery only | $575.44 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | 55 · Aftercare only | $114.82 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | 56 · Pre-op care only | $75.86 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $537.03 | $537.03 | $537.03 |
Where Alabama sits
The same service costs 5.5 times more in Alaska than in Utah. 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· 25th of 51
$759
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.