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 $251.19 Median $891.25 Typical High $1,862.09 | Facility | None | $251.19 | $891.25 | $1,862.09 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $190.55 Typical High $251.19 | Professional | None | $147.91 | $190.55 | $251.19 |
Ambetter Setting Professional Modifier None Typical Low $109.65 Median $128.82 Typical High $144.54 | Professional | None | $109.65 | $128.82 | $144.54 |
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 $97.72 Median $120.23 Typical High $501.19 | Facility | None | $97.72 | $120.23 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $229.09 Typical High $309.03 | Professional | None | $158.49 | $229.09 | $309.03 |
United Setting Facility Modifier None Typical Low $100.00 Median $363.08 Typical High $1,380.38 | Facility | None | $100.00 | $363.08 | $1,380.38 |
United Setting Professional Modifier None Typical Low $83.18 Median $128.82 Typical High $229.09 | Professional | None | $83.18 | $128.82 | $229.09 |
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 $81.28 Median $81.28 Typical High $125.89 | Professional | 52 · Reduced service | $81.28 | $81.28 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $33.11 Typical High $50.12 | Professional | 53 · Discontinued | $33.11 | $33.11 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $123.03 Typical High $190.55 | Professional | 54 · Surgery only | $123.03 | $123.03 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $24.55 Typical High $38.02 | Professional | 55 · Aftercare only | $24.55 | $24.55 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $16.60 Typical High $25.12 | Professional | 56 · Pre-op care only | $16.60 | $16.60 | $25.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $114.82 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $114.82 | $114.82 | $177.83 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 Typical Low $72.44 Median $97.72 Typical High $141.25 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 | $72.44 | $97.72 | $141.25 |
Where Alabama sits
The same service costs 3.2 times more in Alaska than in Texas. 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· 21st of 51
$200
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.