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 $562.34 Median $954.99 Typical High $2,398.83 | Facility | None | $562.34 | $954.99 | $2,398.83 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $154.88 Typical High $181.97 | Professional | None | $117.49 | $154.88 | $181.97 |
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 $131.83 Median $162.18 Typical High $501.19 | Facility | None | $131.83 | $162.18 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $144.54 Typical High $177.83 | Professional | None | $112.20 | $144.54 | $177.83 |
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 $100.00 Median $147.91 Typical High $204.17 | Professional | None | $100.00 | $147.91 | $204.17 |
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 $58.88 Median $77.62 Typical High $91.20 | Professional | 52 · Reduced service | $58.88 | $77.62 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $30.90 Typical High $36.31 | Professional | 53 · Discontinued | $23.44 | $30.90 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $114.82 Typical High $138.04 | Professional | 54 · Surgery only | $87.10 | $114.82 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $22.91 Typical High $27.54 | Professional | 55 · Aftercare only | $17.38 | $22.91 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $15.49 Typical High $18.20 | Professional | 56 · Pre-op care only | $11.75 | $15.49 | $18.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $107.15 Typical High $128.82 | Professional | 78 · Unplanned return to OR | $81.28 | $107.15 | $128.82 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 41 Typical Low $70.79 Median $97.72 Typical High $162.18 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 41 | $70.79 | $97.72 | $162.18 |
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· 40th of 51
$178
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.