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 $89.13 Median $104.71 Typical High $117.49 | Professional | None | $89.13 | $104.71 | $117.49 |
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 $89.13 Median $95.50 Typical High $120.23 | Professional | None | $89.13 | $95.50 | $120.23 |
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 $77.62 Median $102.33 Typical High $151.36 | Professional | None | $77.62 | $102.33 | $151.36 |
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 $44.67 Median $52.48 Typical High $58.88 | Professional | 52 · Reduced service | $44.67 | $52.48 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $20.89 Typical High $23.44 | Professional | 53 · Discontinued | $17.78 | $20.89 | $23.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $77.62 Typical High $87.10 | Professional | 54 · Surgery only | $67.61 | $77.62 | $87.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $15.49 Typical High $17.38 | Professional | 55 · Aftercare only | $13.49 | $15.49 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $10.47 Typical High $11.75 | Professional | 56 · Pre-op care only | $8.91 | $10.47 | $11.75 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $63.10 Median $72.44 Typical High $81.28 | Professional | 78 · Unplanned return to OR | $63.10 | $72.44 | $81.28 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 Typical Low $54.95 Median $74.13 Typical High $125.89 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 | $54.95 | $74.13 | $125.89 |
Where Alabama sits
The same service costs 3.8 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· 38th of 51
$117
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.