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 $2,570.40 Median $2,570.40 Typical High $2,570.40 | Professional | None | $2,570.40 | $2,570.40 | $2,570.40 |
BCBS Alabama Setting Facility Modifier None Typical Low $7,585.78 Median $7,585.78 Typical High $7,585.78 | Facility | None | $7,585.78 | $7,585.78 | $7,585.78 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery Typical Low $1,230.27 Median $1,698.24 Typical High $2,137.96 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery | $1,230.27 | $1,698.24 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $549.54 Typical High $1,202.26 | Facility | None | $446.68 | $549.54 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,380.38 Typical High $1,698.24 | Professional | None | $1,258.93 | $1,380.38 | $1,698.24 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $3,090.30 Typical High $8,128.31 | Facility | None | $1,202.26 | $3,090.30 | $8,128.31 |
United Setting Professional Modifier None Typical Low $977.24 Median $1,258.93 Typical High $2,290.87 | Professional | None | $977.24 | $1,258.93 | $2,290.87 |
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 $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | 52 · Reduced service | $1,288.25 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | 53 · Discontinued | $512.86 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,905.46 Median $1,905.46 Typical High $1,905.46 | Professional | 54 · Surgery only | $1,905.46 | $1,905.46 | $1,905.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | 55 · Aftercare only | $380.19 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | 56 · Pre-op care only | $257.04 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $1,778.28 | $1,778.28 | $1,778.28 |
Where Alabama sits
The same service costs 26.3 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· 28th of 51
$1,549
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.