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 $954.99 Median $1,778.28 Typical High $2,630.27 | Facility | None | $954.99 | $1,778.28 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $2,398.83 Typical High $2,398.83 | Professional | None | $1,412.54 | $2,398.83 | $2,398.83 |
BCBS Alabama Setting Facility Modifier None Typical Low $3,801.89 Median $3,801.89 Typical High $3,801.89 | Facility | None | $3,801.89 | $3,801.89 | $3,801.89 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery Typical Low $1,071.52 Median $1,479.11 Typical High $1,698.24 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery | $1,071.52 | $1,479.11 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $2,884.03 Typical High $3,548.13 | Facility | None | $1,023.29 | $2,884.03 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,148.15 Typical High $1,548.82 | Professional | None | $977.24 | $1,148.15 | $1,548.82 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $3,311.31 Typical High $6,456.54 | Facility | None | $1,288.25 | $3,311.31 | $6,456.54 |
United Setting Professional Modifier None Typical Low $933.25 Median $1,122.02 Typical High $1,778.28 | Professional | None | $933.25 | $1,122.02 | $1,778.28 |
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 $851.14 Median $1,202.26 Typical High $1,202.26 | Professional | 52 · Reduced service | $851.14 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $478.63 Typical High $478.63 | Professional | 53 · Discontinued | $338.84 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,778.28 Typical High $1,778.28 | Professional | 54 · Surgery only | $1,288.25 | $1,778.28 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $354.81 Typical High $354.81 | Professional | 55 · Aftercare only | $257.04 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $239.88 Typical High $239.88 | Professional | 56 · Pre-op care only | $169.82 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,659.59 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,659.59 | $1,659.59 |
Where Alabama sits
The same service costs 5.5 times more in Alaska 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· 12th of 51
$2,399
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.