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 $3,715.35 Median $3,715.35 Typical High $3,715.35 | Professional | None | $3,715.35 | $3,715.35 | $3,715.35 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery Typical Low $1,995.26 Median $2,691.53 Typical High $3,235.94 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery | $1,995.26 | $2,691.53 | $3,235.94 |
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 $1,698.24 Median $1,995.26 Typical High $3,090.30 | Professional | None | $1,698.24 | $1,995.26 | $3,090.30 |
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 $1,479.11 Median $1,862.09 Typical High $2,884.03 | Professional | None | $1,479.11 | $1,862.09 | $2,884.03 |
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 $1,862.09 Median $1,862.09 Typical High $1,862.09 | Professional | 52 · Reduced service | $1,862.09 | $1,862.09 | $1,862.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $741.31 Median $741.31 Typical High $741.31 | Professional | 53 · Discontinued | $741.31 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,754.23 Median $2,754.23 Typical High $2,754.23 | Professional | 54 · Surgery only | $2,754.23 | $2,754.23 | $2,754.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | 55 · Aftercare only | $549.54 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | 56 · Pre-op care only | $371.54 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,570.40 Median $2,570.40 Typical High $2,570.40 | Professional | 78 · Unplanned return to OR | $2,570.40 | $2,570.40 | $2,570.40 |
Where Alabama sits
The same service costs 6.0 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· 41st 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.