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 $794.33 Median $1,513.56 Typical High $2,398.83 | Facility | None | $794.33 | $1,513.56 | $2,398.83 |
Aetna Setting Professional Modifier None Typical Low $9,772.37 Median $9,772.37 Typical High $9,772.37 | Professional | None | $9,772.37 | $9,772.37 | $9,772.37 |
BCBS Alabama Setting Facility Modifier None Typical Low $6,456.54 Median $6,606.93 Typical High $6,606.93 | Facility | None | $6,456.54 | $6,606.93 | $6,606.93 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery Typical Low $3,548.13 Median $4,897.79 Typical High $6,918.31 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery | $3,548.13 | $4,897.79 | $6,918.31 |
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 $2,454.71 Median $5,370.32 Typical High $6,456.54 | Professional | None | $2,454.71 | $5,370.32 | $6,456.54 |
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 $3,630.78 Median $4,897.79 Typical High $8,912.51 | Professional | None | $3,630.78 | $4,897.79 | $8,912.51 |
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 $4,897.79 Median $4,897.79 Typical High $4,897.79 | Professional | 52 · Reduced service | $4,897.79 | $4,897.79 | $4,897.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,949.84 Median $1,949.84 Typical High $1,949.84 | Professional | 53 · Discontinued | $1,949.84 | $1,949.84 | $1,949.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $7,244.36 Median $7,244.36 Typical High $7,244.36 | Professional | 54 · Surgery only | $7,244.36 | $7,244.36 | $7,244.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Professional | 55 · Aftercare only | $1,445.44 | $1,445.44 | $1,445.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $977.24 Median $977.24 Typical High $977.24 | Professional | 56 · Pre-op care only | $977.24 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $6,760.83 Median $6,760.83 Typical High $6,760.83 | Professional | 78 · Unplanned return to OR | $6,760.83 | $6,760.83 | $6,760.83 |
Where Alabama sits
The same service costs 20.0 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
$5,370
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.