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 $645.65 Median $1,230.27 Typical High $2,398.83 | Facility | None | $645.65 | $1,230.27 | $2,398.83 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | None | $537.03 | $537.03 | $537.03 |
BCBS Alabama Setting Facility Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Facility | None | $1,995.26 | $1,995.26 | $1,995.26 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery Typical Low $389.05 Median $537.03 Typical High $549.54 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery | $389.05 | $537.03 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $933.25 Typical High $1,122.02 | Facility | None | $489.78 | $933.25 | $1,122.02 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $562.34 Typical High $562.34 | Professional | None | $457.09 | $562.34 | $562.34 |
United Setting Facility Modifier None Typical Low $467.74 Median $1,000.00 Typical High $3,162.28 | Facility | None | $467.74 | $1,000.00 | $3,162.28 |
United Setting Professional Modifier None Typical Low $269.15 Median $338.84 Typical High $616.60 | Professional | None | $269.15 | $338.84 | $616.60 |
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 $269.15 Median $269.15 Typical High $269.15 | Professional | 52 · Reduced service | $269.15 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | 53 · Discontinued | $107.15 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | 54 · Surgery only | $398.11 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | 55 · Aftercare only | $79.43 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | 56 · Pre-op care only | $53.70 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $371.54 | $371.54 | $371.54 |
BCBS Alabama Setting Facility Modifier 50 · Both sides Typical Low $3,019.95 Median $3,019.95 Typical High $3,019.95 | Facility | 50 · Both sides | $3,019.95 | $3,019.95 | $3,019.95 |
Where Alabama sits
The same service costs 5.8 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· 16th of 51
$562
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.