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 $416.87 Median $537.03 Typical High $707.95 | Professional | None | $416.87 | $537.03 | $707.95 |
BCBS Setting Facility Modifier None Typical Low $4,265.80 Median $4,265.80 Typical High $4,265.80 | Facility | None | $4,265.80 | $4,265.80 | $4,265.80 |
BCBS Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | None | $588.84 | $588.84 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $1,412.54 Typical High $1,737.80 | Facility | None | $489.78 | $1,412.54 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $416.87 Typical High $549.54 | Professional | None | $323.59 | $416.87 | $549.54 |
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 $223.87 Median $309.03 Typical High $524.81 | Professional | None | $223.87 | $309.03 | $524.81 |
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 $263.03 Median $263.03 Typical High $354.81 | Professional | 52 · Reduced service | $263.03 | $263.03 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $107.15 Typical High $141.25 | Professional | 53 · Discontinued | $107.15 | $107.15 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $398.11 Typical High $537.03 | Professional | 54 · Surgery only | $398.11 | $398.11 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $79.43 Typical High $107.15 | Professional | 55 · Aftercare only | $79.43 | $79.43 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $53.70 Typical High $70.79 | Professional | 56 · Pre-op care only | $53.70 | $53.70 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $371.54 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $371.54 | $371.54 | $501.19 |
BCBS Setting Professional Modifier 32 · Mandated service Typical Low $398.11 Median $457.09 Typical High $588.84 | Professional | 32 · Mandated service | $398.11 | $457.09 | $588.84 |
Where Alabama sits
The same service costs 4.1 times more in Alaska than in New Jersey. 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· 22nd of 51
$417
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.