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 $954.99 Median $1,778.28 Typical High $2,630.27 | Facility | None | $954.99 | $1,778.28 | $2,630.27 |
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 $6,606.93 Median $6,760.83 Typical High $6,760.83 | Facility | None | $6,606.93 | $6,760.83 | $6,760.83 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery Typical Low $1,174.90 Median $1,621.81 Typical High $2,089.30 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery | $1,174.90 | $1,621.81 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $2,884.03 Typical High $3,548.13 | Facility | None | $1,023.29 | $2,884.03 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,412.54 Typical High $1,737.80 | Professional | None | $1,202.26 | $1,412.54 | $1,737.80 |
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 $977.24 Median $1,230.27 Typical High $1,862.09 | Professional | None | $977.24 | $1,230.27 | $1,862.09 |
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 $1,348.96 Median $1,348.96 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,348.96 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | 55 · Aftercare only | $269.15 | $269.15 | $269.15 |
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 $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $1,258.93 | $1,258.93 | $1,258.93 |
BCBS Alabama Setting Facility Modifier 50 · Both sides Typical Low $10,000.00 Median $10,000.00 Typical High $10,000.00 | Facility | 50 · Both sides | $10,000.00 | $10,000.00 | $10,000.00 |
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· 25th of 51
$1,820
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.