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 $489.78 Median $933.25 Typical High $1,862.09 | Facility | None | $489.78 | $933.25 | $1,862.09 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $251.19 Typical High $309.03 | Professional | None | $218.78 | $251.19 | $309.03 |
BCBS 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 $208.93 Median $213.80 Typical High $263.03 | Professional | None | $208.93 | $213.80 | $263.03 |
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 $186.21 Median $234.42 Typical High $346.74 | Professional | None | $186.21 | $234.42 | $346.74 |
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 $109.65 Median $120.23 Typical High $134.90 | Professional | 52 · Reduced service | $109.65 | $120.23 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $47.86 Typical High $53.70 | Professional | 53 · Discontinued | $43.65 | $47.86 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $181.97 Typical High $199.53 | Professional | 54 · Surgery only | $162.18 | $181.97 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $36.31 Typical High $39.81 | Professional | 55 · Aftercare only | $32.36 | $36.31 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $23.99 Typical High $26.92 | Professional | 56 · Pre-op care only | $21.88 | $23.99 | $26.92 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $169.82 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $151.36 | $169.82 | $186.21 |
BCBS Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 41 Typical Low $169.82 Median $234.42 Typical High $302.00 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 41 | $169.82 | $234.42 | $302.00 |
Where Alabama sits
The same service costs 3.9 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· 44th of 51
$269
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.