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 $2,630.27 | Facility | None | $776.25 | $1,258.93 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $426.58 Typical High $457.09 | Professional | None | $354.81 | $426.58 | $457.09 |
BCBS Alabama Setting Facility Modifier None Typical Low $1,584.89 Median $1,621.81 Typical High $1,621.81 | Facility | None | $1,584.89 | $1,621.81 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $295.12 Median $371.54 Typical High $501.19 | Facility | None | $295.12 | $371.54 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $416.87 Typical High $588.84 | Professional | None | $338.84 | $416.87 | $588.84 |
United Setting Facility Modifier None Typical Low $309.03 Median $616.60 Typical High $2,570.40 | Facility | None | $309.03 | $616.60 | $2,570.40 |
United Setting Professional Modifier None Typical Low $323.59 Median $446.68 Typical High $660.69 | Professional | None | $323.59 | $446.68 | $660.69 |
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 $177.83 Median $213.80 Typical High $229.09 | Professional | 52 · Reduced service | $177.83 | $213.80 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $85.11 Typical High $91.20 | Professional | 53 · Discontinued | $70.79 | $85.11 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $323.59 Typical High $338.84 | Professional | 54 · Surgery only | $263.03 | $323.59 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $64.57 Typical High $67.61 | Professional | 55 · Aftercare only | $52.48 | $64.57 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $42.66 Typical High $45.71 | Professional | 56 · Pre-op care only | $35.48 | $42.66 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $302.00 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $245.47 | $302.00 | $316.23 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 Typical Low $213.80 Median $295.12 Typical High $524.81 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 | $213.80 | $295.12 | $524.81 |
Where Alabama sits
The same service costs 5.1 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· 41st of 51
$457
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.