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 $208.93 Median $891.25 Typical High $1,862.09 | Facility | None | $208.93 | $891.25 | $1,862.09 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $194.98 Typical High $239.88 | Professional | None | $158.49 | $194.98 | $239.88 |
Ambetter Setting Professional Modifier None Typical Low $63.10 Median $93.33 Typical High $93.33 | Professional | None | $63.10 | $93.33 | $93.33 |
BCBS Alabama Setting Facility Modifier None Typical Low $1,659.59 Median $1,698.24 Typical High $1,698.24 | Facility | None | $1,659.59 | $1,698.24 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $741.31 Typical High $870.96 | Facility | None | $363.08 | $741.31 | $870.96 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $162.18 Typical High $199.53 | Professional | None | $147.91 | $162.18 | $199.53 |
United Setting Facility Modifier None Typical Low $467.74 Median $1,000.00 Typical High $3,162.28 | Facility | None | $467.74 | $1,000.00 | $3,162.28 |
United Setting Professional Modifier None Typical Low $134.90 Median $177.83 Typical High $275.42 | Professional | None | $134.90 | $177.83 | $275.42 |
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 $79.43 Median $91.20 Typical High $104.71 | Professional | 52 · Reduced service | $79.43 | $91.20 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $36.31 Typical High $41.69 | Professional | 53 · Discontinued | $31.62 | $36.31 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $134.90 Typical High $158.49 | Professional | 54 · Surgery only | $117.49 | $134.90 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $26.92 Typical High $31.62 | Professional | 55 · Aftercare only | $23.44 | $26.92 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $18.20 Typical High $20.89 | Professional | 56 · Pre-op care only | $15.85 | $18.20 | $20.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $125.89 Typical High $147.91 | Professional | 78 · Unplanned return to OR | $109.65 | $125.89 | $147.91 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 41 Typical Low $107.15 Median $147.91 Typical High $213.80 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 41 | $107.15 | $147.91 | $213.80 |
Where Alabama sits
The same service costs 4.6 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· 48th of 51
$204
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.