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 $645.65 Median $1,230.27 Typical High $2,398.83 | Facility | None | $645.65 | $1,230.27 | $2,398.83 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $302.00 Typical High $457.09 | Professional | None | $275.42 | $302.00 | $457.09 |
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 $50.12 Median $190.55 Typical High $446.68 | Facility | None | $50.12 | $190.55 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $263.03 Typical High $389.05 | Professional | None | $199.53 | $263.03 | $389.05 |
United Setting Facility Modifier None Typical Low $478.63 Median $1,000.00 Typical High $3,162.28 | Facility | None | $478.63 | $1,000.00 | $3,162.28 |
United Setting Professional Modifier None Typical Low $158.49 Median $229.09 Typical High $316.23 | Professional | None | $158.49 | $229.09 | $316.23 |
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 $151.36 Median $151.36 Typical High $229.09 | Professional | 52 · Reduced service | $151.36 | $151.36 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $60.26 Typical High $91.20 | Professional | 53 · Discontinued | $60.26 | $60.26 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $229.09 Typical High $338.84 | Professional | 54 · Surgery only | $229.09 | $229.09 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $45.71 Typical High $67.61 | Professional | 55 · Aftercare only | $45.71 | $45.71 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $30.20 Typical High $45.71 | Professional | 56 · Pre-op care only | $30.20 | $30.20 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $213.80 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $213.80 | $213.80 | $316.23 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 Typical Low $181.97 Median $251.19 Typical High $275.42 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 | $181.97 | $251.19 | $275.42 |
Where Alabama sits
The same service costs 3.5 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· 25th of 51
$302
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.