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 $645.65 Median $1,230.27 Typical High $2,398.83 | Facility | None | $645.65 | $1,230.27 | $2,398.83 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $138.04 Typical High $169.82 | Professional | None | $104.71 | $138.04 | $169.82 |
Ambetter Setting Professional Modifier None Typical Low $81.28 Median $128.82 Typical High $162.18 | Professional | None | $81.28 | $128.82 | $162.18 |
BCBS Alabama Setting Facility Modifier None Typical Low $645.65 Median $645.65 Typical High $645.65 | Facility | None | $645.65 | $645.65 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $125.89 Typical High $501.19 | Facility | None | $100.00 | $125.89 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $117.49 Typical High $144.54 | Professional | None | $102.33 | $117.49 | $144.54 |
United Setting Facility Modifier None Typical Low $309.03 Median $616.60 Typical High $2,511.89 | Facility | None | $309.03 | $616.60 | $2,511.89 |
United Setting Professional Modifier None Typical Low $91.20 Median $128.82 Typical High $186.21 | Professional | None | $91.20 | $128.82 | $186.21 |
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 $52.48 Median $63.10 Typical High $74.13 | Professional | 52 · Reduced service | $52.48 | $63.10 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $25.70 Typical High $29.51 | Professional | 53 · Discontinued | $20.89 | $25.70 | $29.51 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $95.50 Typical High $112.20 | Professional | 54 · Surgery only | $77.62 | $95.50 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $19.05 Typical High $22.39 | Professional | 55 · Aftercare only | $15.85 | $19.05 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $12.59 Typical High $14.79 | Professional | 56 · Pre-op care only | $10.47 | $12.59 | $14.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $72.44 Median $89.13 Typical High $104.71 | Professional | 78 · Unplanned return to OR | $72.44 | $89.13 | $104.71 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 41 Typical Low $63.10 Median $87.10 Typical High $144.54 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 41 | $63.10 | $87.10 | $144.54 |
Where Alabama sits
The same service costs 3.5 times more in Alaska than in Florida. 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· 41st of 51
$148
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.