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 $102.33 Median $120.23 Typical High $1,584.89 | Facility | None | $102.33 | $120.23 | $1,584.89 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $117.49 Typical High $138.04 | Professional | None | $102.33 | $117.49 | $138.04 |
Ambetter Setting Professional Modifier None Typical Low $100.00 Median $104.71 Typical High $117.49 | Professional | None | $100.00 | $104.71 | $117.49 |
BCBS Alabama Setting Facility Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Facility | None | $239.88 | $239.88 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $89.13 Typical High $446.68 | Facility | None | $50.12 | $89.13 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $104.71 Typical High $151.36 | Professional | None | $87.10 | $104.71 | $151.36 |
United Setting Facility Modifier None Typical Low $100.00 Median $363.08 Typical High $1,380.38 | Facility | None | $100.00 | $363.08 | $1,380.38 |
United Setting Professional Modifier None Typical Low $81.28 Median $97.72 Typical High $147.91 | Professional | None | $81.28 | $97.72 | $147.91 |
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 $51.29 Median $53.70 Typical High $60.26 | Professional | 52 · Reduced service | $51.29 | $53.70 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $21.38 Typical High $23.99 | Professional | 53 · Discontinued | $20.42 | $21.38 | $23.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $79.43 Typical High $89.13 | Professional | 54 · Surgery only | $75.86 | $79.43 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $15.85 Typical High $17.78 | Professional | 55 · Aftercare only | $15.14 | $15.85 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $10.72 Typical High $12.02 | Professional | 56 · Pre-op care only | $10.23 | $10.72 | $12.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $74.13 Typical High $83.18 | Professional | 78 · Unplanned return to OR | $70.79 | $74.13 | $83.18 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 Typical Low $61.66 Median $85.11 Typical High $138.04 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 | $61.66 | $85.11 | $138.04 |
Where Alabama sits
The same service costs 4.4 times more in Alaska than in Kentucky. 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· 37th of 51
$120
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.