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 $46.77 Median $46.77 Typical High $50.12 | Professional | None | $46.77 | $46.77 | $50.12 |
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 $39.81 Median $46.77 Typical High $48.98 | Professional | None | $39.81 | $46.77 | $48.98 |
United Setting Facility Modifier None Typical Low $97.72 Median $363.08 Typical High $1,380.38 | Facility | None | $97.72 | $363.08 | $1,380.38 |
United Setting Professional Modifier None Typical Low $38.02 Median $46.77 Typical High $70.79 | Professional | None | $38.02 | $46.77 | $70.79 |
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 $23.44 Median $23.44 Typical High $25.12 | Professional | 52 · Reduced service | $23.44 | $23.44 | $25.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $9.33 Typical High $10.00 | Professional | 53 · Discontinued | $9.33 | $9.33 | $10.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $35.48 Typical High $38.02 | Professional | 54 · Surgery only | $35.48 | $35.48 | $38.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $7.08 Typical High $7.59 | Professional | 55 · Aftercare only | $7.08 | $7.08 | $7.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $4.68 Typical High $5.01 | Professional | 56 · Pre-op care only | $4.68 | $4.68 | $5.01 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $33.11 Median $33.11 Typical High $35.48 | Professional | 78 · Unplanned return to OR | $33.11 | $33.11 | $35.48 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 Typical Low $30.20 Median $41.69 Typical High $66.07 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 | $30.20 | $41.69 | $66.07 |
Where Alabama sits
The same service costs 4.6 times more in Alaska than in New York. 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· 44th of 51
$50.12
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.