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 $616.60 Median $1,122.02 Typical High $1,905.46 | Facility | None | $616.60 | $1,122.02 | $1,905.46 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $338.84 Typical High $416.87 | Professional | None | $229.09 | $338.84 | $416.87 |
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 $213.80 Median $263.03 Typical High $630.96 | Facility | None | $213.80 | $263.03 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $316.23 Typical High $407.38 | Professional | None | $229.09 | $316.23 | $407.38 |
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 $204.17 Median $309.03 Typical High $426.58 | Professional | None | $204.17 | $309.03 | $426.58 |
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 $114.82 Median $151.36 Typical High $181.97 | Professional | 52 · Reduced service | $114.82 | $151.36 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $61.66 Typical High $72.44 | Professional | 53 · Discontinued | $45.71 | $61.66 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $229.09 Typical High $269.15 | Professional | 54 · Surgery only | $173.78 | $229.09 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $45.71 Typical High $53.70 | Professional | 55 · Aftercare only | $34.67 | $45.71 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $30.20 Typical High $36.31 | Professional | 56 · Pre-op care only | $22.91 | $30.20 | $36.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $213.80 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $162.18 | $213.80 | $251.19 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 Typical Low $141.25 Median $190.55 Typical High $323.59 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 | $141.25 | $190.55 | $323.59 |
Where Alabama sits
The same service costs 3.5 times more in Alaska than in Maryland. 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
$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.