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 $6,025.60 Median $6,025.60 Typical High $6,025.60 | Professional | None | $6,025.60 | $6,025.60 | $6,025.60 |
BCBS Alabama Setting Facility Modifier None Typical Low $6,918.31 Median $7,079.46 Typical High $7,079.46 | Facility | None | $6,918.31 | $7,079.46 | $7,079.46 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery Typical Low $3,388.44 Median $4,570.88 Typical High $6,025.60 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery | $3,388.44 | $4,570.88 | $6,025.60 |
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 $4,265.80 Median $5,754.40 Typical High $6,165.95 | Professional | None | $4,265.80 | $5,754.40 | $6,165.95 |
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 $3,162.28 Median $3,890.45 Typical High $6,309.57 | Professional | None | $3,162.28 | $3,890.45 | $6,309.57 |
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 $3,019.95 Median $3,019.95 Typical High $3,019.95 | Professional | 52 · Reduced service | $3,019.95 | $3,019.95 | $3,019.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | 53 · Discontinued | $1,202.26 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $4,570.88 Median $4,570.88 Typical High $4,570.88 | Professional | 54 · Surgery only | $4,570.88 | $4,570.88 | $4,570.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $912.01 Median $912.01 Typical High $912.01 | Professional | 55 · Aftercare only | $912.01 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | 56 · Pre-op care only | $602.56 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $4,265.80 Median $4,265.80 Typical High $4,265.80 | Professional | 78 · Unplanned return to OR | $4,265.80 | $4,265.80 | $4,265.80 |
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· 17th of 51
$5,754
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.