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 $891.25 Median $1,348.96 Typical High $2,398.83 | Facility | None | $891.25 | $1,348.96 | $2,398.83 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | None | $794.33 | $794.33 | $794.33 |
BCBS Alabama Setting Facility Modifier None Typical Low $6,165.95 Median $6,165.95 Typical High $6,165.95 | Facility | None | $6,165.95 | $6,165.95 | $6,165.95 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery Typical Low $549.54 Median $758.58 Typical High $977.24 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery | $549.54 | $758.58 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $2,187.76 Typical High $2,691.53 | Facility | None | $741.31 | $2,187.76 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $616.60 Typical High $831.76 | Professional | None | $478.63 | $616.60 | $831.76 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $3,311.31 Typical High $6,456.54 | Facility | None | $1,288.25 | $3,311.31 | $6,456.54 |
United Setting Professional Modifier None Typical Low $457.09 Median $562.34 Typical High $794.33 | Professional | None | $457.09 | $562.34 | $794.33 |
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 $398.11 Median $398.11 Typical High $398.11 | Professional | 52 · Reduced service | $398.11 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | 53 · Discontinued | $158.49 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | 54 · Surgery only | $602.56 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | 55 · Aftercare only | $120.23 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | 56 · Pre-op care only | $79.43 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $562.34 | $562.34 | $562.34 |
Where Alabama sits
The same service costs 6.9 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· 29th of 51
$851
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.