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 $776.25 Median $1,258.93 Typical High $2,398.83 | Facility | None | $776.25 | $1,258.93 | $2,398.83 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $912.01 Typical High $1,096.48 | Professional | None | $776.25 | $912.01 | $1,096.48 |
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 $691.83 Median $794.33 Typical High $1,288.25 | Professional | None | $691.83 | $794.33 | $1,288.25 |
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 $676.08 Median $831.76 Typical High $1,258.93 | Professional | None | $676.08 | $831.76 | $1,258.93 |
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 $389.05 Median $426.58 Typical High $467.74 | Professional | 52 · Reduced service | $389.05 | $426.58 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $169.82 Typical High $190.55 | Professional | 53 · Discontinued | $154.88 | $169.82 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $630.96 Typical High $707.95 | Professional | 54 · Surgery only | $588.84 | $630.96 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $128.82 Typical High $141.25 | Professional | 55 · Aftercare only | $117.49 | $128.82 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $85.11 Typical High $95.50 | Professional | 56 · Pre-op care only | $77.62 | $85.11 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $588.84 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $549.54 | $588.84 | $660.69 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 Typical Low $831.76 Median $1,096.48 Typical High $1,174.90 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 | $831.76 | $1,096.48 | $1,174.90 |
Where Alabama sits
The same service costs 4.5 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· 40th of 51
$933
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.