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 $3,388.44 Median $3,467.37 Typical High $3,467.37 | Professional | None | $3,388.44 | $3,467.37 | $3,467.37 |
BCBS Setting Facility Modifier None Typical Low $3,630.78 Median $3,715.35 Typical High $3,715.35 | Facility | None | $3,630.78 | $3,715.35 | $3,715.35 |
BCBS Setting Professional Modifier 21 Typical Low $1,584.89 Median $2,187.76 Typical High $2,691.53 | Professional | 21 | $1,584.89 | $2,187.76 | $2,691.53 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $549.54 Typical High $1,202.26 | Facility | None | $446.68 | $549.54 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $1,778.28 Median $1,905.46 Typical High $2,344.23 | Professional | None | $1,778.28 | $1,905.46 | $2,344.23 |
United Setting Facility Modifier None Typical Low $371.54 Median $954.99 Typical High $3,801.89 | Facility | None | $371.54 | $954.99 | $3,801.89 |
United Setting Professional Modifier None Typical Low $1,318.26 Median $1,698.24 Typical High $3,090.30 | Professional | None | $1,318.26 | $1,698.24 | $3,090.30 |
6 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 $1,698.24 Median $1,698.24 Typical High $1,698.24 | Professional | 52 · Reduced service | $1,698.24 | $1,698.24 | $1,698.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | 53 · Discontinued | $691.83 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,570.40 Median $2,570.40 Typical High $2,570.40 | Professional | 54 · Surgery only | $2,570.40 | $2,570.40 | $2,570.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | 55 · Aftercare only | $512.86 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | 56 · Pre-op care only | $346.74 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Professional | 78 · Unplanned return to OR | $2,398.83 | $2,398.83 | $2,398.83 |
Where Alabama sits
The same service costs 5.4 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· 31st of 51
$1,995
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.