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 $4,786.30 Median $4,897.79 Typical High $4,897.79 | Professional | None | $4,786.30 | $4,897.79 | $4,897.79 |
BCBS Alabama Setting Facility Modifier None Typical Low $7,244.36 Median $7,413.10 Typical High $7,413.10 | Facility | None | $7,244.36 | $7,413.10 | $7,413.10 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery Typical Low $1,862.09 Median $2,570.40 Typical High $3,467.37 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery | $1,862.09 | $2,570.40 | $3,467.37 |
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 $2,344.23 Median $2,691.53 Typical High $3,162.28 | Professional | None | $2,344.23 | $2,691.53 | $3,162.28 |
United Setting Facility Modifier None Typical Low $371.54 Median $954.99 Typical High $3,801.89 | Facility | None | $371.54 | $954.99 | $3,801.89 |
United Setting Professional Modifier None Typical Low $1,862.09 Median $2,398.83 Typical High $4,365.16 | Professional | None | $1,862.09 | $2,398.83 | $4,365.16 |
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 $2,454.71 Median $2,454.71 Typical High $2,454.71 | Professional | 52 · Reduced service | $2,454.71 | $2,454.71 | $2,454.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $977.24 Median $977.24 Typical High $977.24 | Professional | 53 · Discontinued | $977.24 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,630.78 Median $3,630.78 Typical High $3,630.78 | Professional | 54 · Surgery only | $3,630.78 | $3,630.78 | $3,630.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $741.31 Median $741.31 Typical High $741.31 | Professional | 55 · Aftercare only | $741.31 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | 56 · Pre-op care only | $489.78 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,388.44 Median $3,388.44 Typical High $3,388.44 | Professional | 78 · Unplanned return to OR | $3,388.44 | $3,388.44 | $3,388.44 |
Where Alabama sits
The same service costs 21.4 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· 32nd of 51
$2,692
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.