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 $562.34 Median $954.99 Typical High $2,398.83 | Facility | None | $562.34 | $954.99 | $2,398.83 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $416.87 | Professional | None | $251.19 | $251.19 | $416.87 |
BCBS Alabama Setting Facility Modifier None Typical Low $3,235.94 Median $3,311.31 Typical High $3,311.31 | Facility | None | $3,235.94 | $3,311.31 | $3,311.31 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $741.31 Typical High $870.96 | Facility | None | $363.08 | $741.31 | $870.96 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $223.87 Typical High $302.00 | Professional | None | $158.49 | $223.87 | $302.00 |
United Setting Facility Modifier None Typical Low $467.74 Median $1,000.00 Typical High $3,162.28 | Facility | None | $467.74 | $1,000.00 | $3,162.28 |
United Setting Professional Modifier None Typical Low $128.82 Median $208.93 Typical High $346.74 | Professional | None | $128.82 | $208.93 | $346.74 |
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 $125.89 Median $125.89 Typical High $208.93 | Professional | 52 · Reduced service | $125.89 | $125.89 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $50.12 Typical High $83.18 | Professional | 53 · Discontinued | $50.12 | $50.12 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $186.21 Typical High $309.03 | Professional | 54 · Surgery only | $186.21 | $186.21 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $38.02 Typical High $61.66 | Professional | 55 · Aftercare only | $38.02 | $38.02 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $25.12 Typical High $41.69 | Professional | 56 · Pre-op care only | $25.12 | $25.12 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $173.78 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $173.78 | $173.78 | $288.40 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 Typical Low $109.65 Median $151.36 Typical High $213.80 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 | $109.65 | $151.36 | $213.80 |
Where Alabama sits
The same service costs 4.5 times more in Alaska than in Kentucky. 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· 32nd of 51
$257
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.