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 $676.08 Median $741.31 Typical High $812.83 | Professional | None | $676.08 | $741.31 | $812.83 |
BCBS Alabama Setting Facility Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $2,570.40 | Facility | None | $2,570.40 | $2,570.40 | $2,570.40 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $1,230.27 Typical High $1,737.80 | Facility | None | $549.54 | $1,230.27 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $691.83 Typical High $851.14 | Professional | None | $575.44 | $691.83 | $851.14 |
United Setting Facility Modifier None Typical Low $467.74 Median $1,000.00 Typical High $3,235.94 | Facility | None | $467.74 | $1,000.00 | $3,235.94 |
United Setting Professional Modifier None Typical Low $588.84 Median $707.95 Typical High $1,071.52 | Professional | None | $588.84 | $707.95 | $1,071.52 |
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 $338.84 Median $371.54 Typical High $407.38 | Professional | 52 · Reduced service | $338.84 | $371.54 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $147.91 Typical High $162.18 | Professional | 53 · Discontinued | $134.90 | $147.91 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $562.34 Typical High $616.60 | Professional | 54 · Surgery only | $512.86 | $562.34 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $112.20 Typical High $123.03 | Professional | 55 · Aftercare only | $102.33 | $112.20 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $74.13 Typical High $81.28 | Professional | 56 · Pre-op care only | $67.61 | $74.13 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $524.81 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $478.63 | $524.81 | $575.44 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 Typical Low $616.60 Median $851.14 Typical High $1,071.52 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 | $616.60 | $851.14 | $1,071.52 |
Where Alabama sits
The same service costs 4.9 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· 38th of 51
$813
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.