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 $100.00 Median $141.25 Typical High $1,584.89 | Facility | None | $100.00 | $141.25 | $1,584.89 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $128.82 Typical High $162.18 | Professional | None | $100.00 | $128.82 | $162.18 |
Ambetter Setting Professional Modifier None Typical Low $79.43 Median $85.11 Typical High $109.65 | Professional | None | $79.43 | $85.11 | $109.65 |
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 $114.82 Typical High $446.68 | Facility | None | $50.12 | $114.82 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $134.90 Typical High $165.96 | Professional | None | $93.33 | $134.90 | $165.96 |
United Setting Facility Modifier None Typical Low $100.00 Median $371.54 Typical High $1,380.38 | Facility | None | $100.00 | $371.54 | $1,380.38 |
United Setting Professional Modifier None Typical Low $85.11 Median $120.23 Typical High $173.78 | Professional | None | $85.11 | $120.23 | $173.78 |
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 $50.12 Median $60.26 Typical High $70.79 | Professional | 52 · Reduced service | $50.12 | $60.26 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $23.99 Typical High $28.18 | Professional | 53 · Discontinued | $19.95 | $23.99 | $28.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $89.13 Typical High $104.71 | Professional | 54 · Surgery only | $75.86 | $89.13 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $17.78 Typical High $20.89 | Professional | 55 · Aftercare only | $15.14 | $17.78 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $12.02 Typical High $14.13 | Professional | 56 · Pre-op care only | $10.00 | $12.02 | $14.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $83.18 Typical High $97.72 | Professional | 78 · Unplanned return to OR | $70.79 | $83.18 | $97.72 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 Typical Low $60.26 Median $83.18 Typical High $134.90 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 | $60.26 | $83.18 | $134.90 |
Where Alabama sits
The same service costs 4.1 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· 35th of 51
$141
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.