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 $169.82 Median $616.60 Typical High $1,737.80 | Facility | None | $169.82 | $616.60 | $1,737.80 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $194.98 Typical High $288.40 | Professional | None | $162.18 | $194.98 | $288.40 |
Ambetter Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | None | $64.57 | $64.57 | $64.57 |
BCBS Alabama Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Facility | None | $95.50 | $95.50 | $95.50 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $128.82 Typical High $446.68 | Facility | None | $50.12 | $128.82 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $165.96 Typical High $239.88 | Professional | None | $117.49 | $165.96 | $239.88 |
United Setting Facility Modifier None Typical Low $100.00 Median $371.54 Typical High $1,380.38 | Facility | None | $100.00 | $371.54 | $1,380.38 |
United Setting Professional Modifier None Typical Low $95.50 Median $154.88 Typical High $218.78 | Professional | None | $95.50 | $154.88 | $218.78 |
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 $87.10 Median $87.10 Typical High $144.54 | Professional | 52 · Reduced service | $87.10 | $87.10 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $34.67 Typical High $57.54 | Professional | 53 · Discontinued | $34.67 | $34.67 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $131.83 Typical High $213.80 | Professional | 54 · Surgery only | $131.83 | $131.83 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $26.30 Typical High $42.66 | Professional | 55 · Aftercare only | $26.30 | $26.30 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $17.38 Typical High $28.84 | Professional | 56 · Pre-op care only | $17.38 | $17.38 | $28.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $123.03 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $123.03 | $123.03 | $199.53 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 Typical Low $63.10 Median $87.10 Typical High $151.36 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 | $63.10 | $87.10 | $151.36 |
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
$174
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.