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 $1,584.89 Typical High $2,570.40 | Facility | None | $954.99 | $1,584.89 | $2,570.40 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | None | $1,202.26 | $1,202.26 | $1,202.26 |
BCBS Alabama Setting Facility Modifier None Typical Low $2,818.38 Median $2,884.03 Typical High $2,884.03 | Facility | None | $2,818.38 | $2,884.03 | $2,884.03 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery Typical Low $831.76 Median $1,122.02 Typical High $1,288.25 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery | $831.76 | $1,122.02 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $2,884.03 Typical High $3,548.13 | Facility | None | $741.31 | $2,884.03 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $812.83 Typical High $1,230.27 | Professional | None | $676.08 | $812.83 | $1,230.27 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $3,801.89 Typical High $8,317.64 | Facility | None | $1,698.24 | $3,801.89 | $8,317.64 |
United Setting Professional Modifier None Typical Low $588.84 Median $758.58 Typical High $1,096.48 | Professional | None | $588.84 | $758.58 | $1,096.48 |
7 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 $602.56 Median $602.56 Typical High $602.56 | Professional | 52 · Reduced service | $602.56 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | 53 · Discontinued | $239.88 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $891.25 Typical High $891.25 | Professional | 54 · Surgery only | $891.25 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | 55 · Aftercare only | $177.83 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | 56 · Pre-op care only | $120.23 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $831.76 | $831.76 | $831.76 |
BCBS Alabama Setting Facility Modifier 50 · Both sides Typical Low $4,265.80 Median $4,265.80 Typical High $4,265.80 | Facility | 50 · Both sides | $4,265.80 | $4,265.80 | $4,265.80 |
Where Alabama sits
The same service costs 7.2 times more in Oklahoma 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
$1,202
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.