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 $162.18 Median $562.34 Typical High $1,737.80 | Facility | None | $162.18 | $562.34 | $1,737.80 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $239.88 Typical High $302.00 | Professional | None | $162.18 | $239.88 | $302.00 |
Ambetter Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | None | $77.62 | $77.62 | $77.62 |
BCBS 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 $50.12 Median $199.53 Typical High $446.68 | Facility | None | $50.12 | $199.53 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $223.87 Typical High $309.03 | Professional | None | $186.21 | $223.87 | $309.03 |
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 $141.25 Median $213.80 Typical High $295.12 | Professional | None | $141.25 | $213.80 | $295.12 |
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 $102.33 Typical High $131.83 | Professional | 52 · Reduced service | $81.28 | $102.33 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $40.74 Typical High $52.48 | Professional | 53 · Discontinued | $32.36 | $40.74 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $151.36 Typical High $194.98 | Professional | 54 · Surgery only | $120.23 | $151.36 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $30.90 Typical High $38.90 | Professional | 55 · Aftercare only | $23.99 | $30.90 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $20.42 Typical High $26.30 | Professional | 56 · Pre-op care only | $16.22 | $20.42 | $26.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $141.25 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $112.20 | $141.25 | $181.97 |
BCBS Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 Typical Low $97.72 Median $134.90 Typical High $223.87 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 | $97.72 | $134.90 | $223.87 |
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· 29th of 51
$263
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.