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 $288.40 Median $1,096.48 Typical High $1,905.46 | Facility | None | $288.40 | $1,096.48 | $1,905.46 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $269.15 Typical High $331.13 | Professional | None | $204.17 | $269.15 | $331.13 |
Ambetter Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $257.04 | Professional | None | $218.78 | $218.78 | $257.04 |
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 $371.54 Median $457.09 Typical High $630.96 | Facility | None | $371.54 | $457.09 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $234.42 Typical High $288.40 | Professional | None | $194.98 | $234.42 | $288.40 |
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 $177.83 Median $239.88 Typical High $371.54 | Professional | None | $177.83 | $239.88 | $371.54 |
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 $102.33 Median $128.82 Typical High $144.54 | Professional | 52 · Reduced service | $102.33 | $128.82 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $51.29 Typical High $58.88 | Professional | 53 · Discontinued | $40.74 | $51.29 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $190.55 Typical High $218.78 | Professional | 54 · Surgery only | $151.36 | $190.55 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $38.02 Typical High $43.65 | Professional | 55 · Aftercare only | $30.20 | $38.02 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $25.70 Typical High $28.84 | Professional | 56 · Pre-op care only | $20.42 | $25.70 | $28.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $177.83 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $141.25 | $177.83 | $204.17 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 41 Typical Low $162.18 Median $218.78 Typical High $295.12 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 41 | $162.18 | $218.78 | $295.12 |
Where Alabama sits
The same service costs 3.6 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· 39th of 51
$288
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.