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 $645.65 Median $1,230.27 Typical High $2,398.83 | Facility | None | $645.65 | $1,230.27 | $2,398.83 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $707.95 Typical High $794.33 | Professional | None | $575.44 | $707.95 | $794.33 |
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 $489.78 Median $1,071.52 Typical High $1,318.26 | Facility | None | $489.78 | $1,071.52 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $575.44 Typical High $707.95 | Professional | None | $512.86 | $575.44 | $707.95 |
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 $501.19 Median $630.96 Typical High $954.99 | Professional | None | $501.19 | $630.96 | $954.99 |
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 $288.40 Median $331.13 Typical High $363.08 | Professional | 52 · Reduced service | $288.40 | $331.13 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $131.83 Typical High $144.54 | Professional | 53 · Discontinued | $114.82 | $131.83 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $489.78 Typical High $537.03 | Professional | 54 · Surgery only | $436.52 | $489.78 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $97.72 Typical High $109.65 | Professional | 55 · Aftercare only | $87.10 | $97.72 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $66.07 Typical High $72.44 | Professional | 56 · Pre-op care only | $57.54 | $66.07 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $457.09 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $407.38 | $457.09 | $501.19 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 Typical Low $478.63 Median $660.69 Typical High $794.33 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 | $478.63 | $660.69 | $794.33 |
Where Alabama sits
The same service costs 4.2 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
$708
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.