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 $128.82 Median $186.21 Typical High $213.80 | Professional | None | $128.82 | $186.21 | $213.80 |
BCBS Alabama Setting Facility Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Facility | None | $239.88 | $239.88 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $102.33 Typical High $512.86 | Facility | None | $50.12 | $102.33 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $181.97 Typical High $223.87 | Professional | None | $128.82 | $181.97 | $223.87 |
United Setting Facility Modifier None Typical Low $100.00 Median $363.08 Typical High $1,380.38 | Facility | None | $100.00 | $363.08 | $1,380.38 |
United Setting Professional Modifier None Typical Low $112.20 Median $190.55 Typical High $251.19 | Professional | None | $112.20 | $190.55 | $251.19 |
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 $64.57 Median $93.33 Typical High $107.15 | Professional | 52 · Reduced service | $64.57 | $93.33 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $37.15 Typical High $42.66 | Professional | 53 · Discontinued | $25.70 | $37.15 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $138.04 Typical High $158.49 | Professional | 54 · Surgery only | $97.72 | $138.04 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $28.18 Typical High $31.62 | Professional | 55 · Aftercare only | $19.50 | $28.18 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $18.62 Typical High $21.38 | Professional | 56 · Pre-op care only | $12.88 | $18.62 | $21.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $128.82 Typical High $147.91 | Professional | 78 · Unplanned return to OR | $91.20 | $128.82 | $147.91 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 Typical Low $79.43 Median $107.15 Typical High $181.97 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 | $79.43 | $107.15 | $181.97 |
Where Alabama sits
The same service costs 3.8 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· 28th of 51
$214
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.