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 $660.69 Median $1,096.48 Typical High $2,089.30 | Facility | None | $660.69 | $1,096.48 | $2,089.30 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $602.56 Typical High $676.08 | Professional | None | $537.03 | $602.56 | $676.08 |
BCBS Alabama Setting Facility Modifier None Typical Low $2,818.38 Median $2,884.03 Typical High $2,884.03 | Facility | None | $2,818.38 | $2,884.03 | $2,884.03 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $1,071.52 Typical High $1,318.26 | Facility | None | $549.54 | $1,071.52 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $537.03 Typical High $645.65 | Professional | None | $489.78 | $537.03 | $645.65 |
United Setting Facility Modifier None Typical Low $467.74 Median $1,000.00 Typical High $3,162.28 | Facility | None | $467.74 | $1,000.00 | $3,162.28 |
United Setting Professional Modifier None Typical Low $457.09 Median $575.44 Typical High $851.14 | Professional | None | $457.09 | $575.44 | $851.14 |
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 $269.15 Median $302.00 Typical High $331.13 | Professional | 52 · Reduced service | $269.15 | $302.00 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $120.23 Typical High $131.83 | Professional | 53 · Discontinued | $107.15 | $120.23 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $446.68 Typical High $501.19 | Professional | 54 · Surgery only | $407.38 | $446.68 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $89.13 Typical High $100.00 | Professional | 55 · Aftercare only | $81.28 | $89.13 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $60.26 Typical High $66.07 | Professional | 56 · Pre-op care only | $53.70 | $60.26 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $416.87 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $380.19 | $416.87 | $467.74 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 Typical Low $338.84 Median $457.09 Typical High $741.31 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 | $338.84 | $457.09 | $741.31 |
Where Alabama sits
The same service costs 4.3 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· 42nd of 51
$646
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.