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 $204.17 Median $288.40 Typical High $398.11 | Professional | None | $204.17 | $288.40 | $398.11 |
Ambetter Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | None | $199.53 | $199.53 | $199.53 |
BCBS Alabama Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $478.63 Typical High $630.96 | Facility | None | $389.05 | $478.63 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $269.15 Typical High $380.19 | Professional | None | $194.98 | $269.15 | $380.19 |
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 $177.83 Median $281.84 Typical High $363.08 | Professional | None | $177.83 | $281.84 | $363.08 |
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 $141.25 Typical High $177.83 | Professional | 52 · Reduced service | $102.33 | $141.25 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $56.23 Typical High $70.79 | Professional | 53 · Discontinued | $40.74 | $56.23 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $213.80 Typical High $263.03 | Professional | 54 · Surgery only | $154.88 | $213.80 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $42.66 Typical High $53.70 | Professional | 55 · Aftercare only | $30.90 | $42.66 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $28.18 Typical High $35.48 | Professional | 56 · Pre-op care only | $20.42 | $28.18 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $199.53 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $144.54 | $199.53 | $245.47 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 Typical Low $123.03 Median $169.82 Typical High $295.12 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 | $123.03 | $169.82 | $295.12 |
Where Alabama sits
The same service costs 3.4 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· 30th of 51
$355
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.