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 $2,398.83 | Facility | None | $776.25 | $1,258.93 | $2,398.83 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $2,089.30 Typical High $2,089.30 | Professional | None | $1,380.38 | $2,089.30 | $2,089.30 |
BCBS Alabama Setting Facility Modifier None Typical Low $4,897.79 Median $4,897.79 Typical High $4,897.79 | Facility | None | $4,897.79 | $4,897.79 | $4,897.79 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery Typical Low $933.25 Median $1,258.93 Typical High $1,513.56 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery | $933.25 | $1,258.93 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $1,202.26 Typical High $1,479.11 | Facility | None | $549.54 | $1,202.26 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,096.48 Typical High $1,348.96 | Professional | None | $933.25 | $1,096.48 | $1,348.96 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $3,090.30 Typical High $6,309.57 | Facility | None | $1,288.25 | $3,090.30 | $6,309.57 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,023.29 Typical High $1,380.38 | Professional | None | $891.25 | $1,023.29 | $1,380.38 |
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 $741.31 Median $1,047.13 Typical High $1,047.13 | Professional | 52 · Reduced service | $741.31 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $416.87 Typical High $416.87 | Professional | 53 · Discontinued | $295.12 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,548.82 Typical High $1,548.82 | Professional | 54 · Surgery only | $1,122.02 | $1,548.82 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $309.03 Typical High $309.03 | Professional | 55 · Aftercare only | $223.87 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $208.93 Typical High $208.93 | Professional | 56 · Pre-op care only | $147.91 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,445.44 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,445.44 | $1,445.44 |
BCBS Alabama Setting Facility Modifier 50 · Both sides Typical Low $7,413.10 Median $7,413.10 Typical High $7,413.10 | Facility | 50 · Both sides | $7,413.10 | $7,413.10 | $7,413.10 |
Where Alabama sits
The same service costs 7.6 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· 8th of 51
$2,089
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.