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 $1,819.70 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,819.70 | $1,819.70 | $1,819.70 |
BCBS Alabama Setting Facility Modifier None Typical Low $6,918.31 Median $6,918.31 Typical High $6,918.31 | Facility | None | $6,918.31 | $6,918.31 | $6,918.31 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery Typical Low $870.96 Median $1,174.90 Typical High $1,584.89 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery | $870.96 | $1,174.90 | $1,584.89 |
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 $1,174.90 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,174.90 | $1,659.59 | $1,659.59 |
United Setting Facility Modifier None Typical Low $1,096.48 Median $2,344.23 Typical High $5,128.61 | Facility | None | $1,096.48 | $2,344.23 | $5,128.61 |
United Setting Professional Modifier None Typical Low $912.01 Median $1,148.15 Typical High $1,905.46 | Professional | None | $912.01 | $1,148.15 | $1,905.46 |
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 $912.01 Median $912.01 Typical High $912.01 | Professional | 52 · Reduced service | $912.01 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | 53 · Discontinued | $363.08 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,380.38 | $1,380.38 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | 55 · Aftercare only | $275.42 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | 56 · Pre-op care only | $181.97 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $1,288.25 | $1,288.25 | $1,288.25 |
BCBS Alabama Setting Facility Modifier 50 · Both sides Typical Low $10,232.93 Median $10,232.93 Typical High $10,232.93 | Facility | 50 · Both sides | $10,232.93 | $10,232.93 | $10,232.93 |
Where Alabama sits
The same service costs 6.2 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· 17th of 51
$1,738
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.