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 $2,398.83 | Facility | None | $776.25 | $1,258.93 | $2,398.83 |
Aetna Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,584.89 | $1,584.89 | $1,584.89 |
BCBS Alabama Setting Facility Modifier None Typical Low $4,677.35 Median $4,677.35 Typical High $4,677.35 | Facility | None | $4,677.35 | $4,677.35 | $4,677.35 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery Typical Low $1,071.52 Median $1,445.44 Typical High $1,737.80 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery | $1,071.52 | $1,445.44 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $2,570.40 Typical High $3,235.94 | Facility | None | $549.54 | $2,570.40 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,096.48 Typical High $1,659.59 | Professional | None | $933.25 | $1,096.48 | $1,659.59 |
United Setting Facility Modifier None Typical Low $1,096.48 Median $2,454.71 Typical High $5,370.32 | Facility | None | $1,096.48 | $2,454.71 | $5,370.32 |
United Setting Professional Modifier None Typical Low $794.33 Median $1,000.00 Typical High $1,380.38 | Professional | None | $794.33 | $1,000.00 | $1,380.38 |
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 $794.33 Median $794.33 Typical High $794.33 | Professional | 52 · Reduced service | $794.33 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | 53 · Discontinued | $316.23 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | 54 · Surgery only | $1,202.26 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | 55 · Aftercare only | $239.88 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | 56 · Pre-op care only | $158.49 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,122.02 | $1,122.02 |
Where Alabama sits
The same service costs 5.6 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· 21st of 51
$1,585
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.