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 $363.08 Median $1,096.48 Typical High $2,089.30 | Facility | None | $363.08 | $1,096.48 | $2,089.30 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $346.74 Typical High $416.87 | Professional | None | $234.42 | $346.74 | $416.87 |
Ambetter Setting Professional Modifier None Typical Low $269.15 Median $323.59 Typical High $323.59 | Professional | None | $269.15 | $323.59 | $323.59 |
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 $389.05 Median $478.63 Typical High $812.83 | Facility | None | $389.05 | $478.63 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $316.23 Typical High $416.87 | Professional | None | $229.09 | $316.23 | $416.87 |
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 $204.17 Median $316.23 Typical High $436.52 | Professional | None | $204.17 | $316.23 | $436.52 |
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 $117.49 Median $154.88 Typical High $181.97 | Professional | 52 · Reduced service | $117.49 | $154.88 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $63.10 Typical High $72.44 | Professional | 53 · Discontinued | $46.77 | $63.10 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $234.42 Typical High $275.42 | Professional | 54 · Surgery only | $173.78 | $234.42 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $46.77 Typical High $54.95 | Professional | 55 · Aftercare only | $35.48 | $46.77 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $30.90 Typical High $36.31 | Professional | 56 · Pre-op care only | $23.44 | $30.90 | $36.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $218.78 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $162.18 | $218.78 | $257.04 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 Typical Low $141.25 Median $194.98 Typical High $323.59 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 | $141.25 | $194.98 | $323.59 |
Where Alabama sits
The same service costs 3.3 times more in Alaska than in Utah. 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
$363
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.