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 $223.87 Median $223.87 Typical High $281.84 | Professional | None | $223.87 | $223.87 | $281.84 |
BCBS Alabama Setting Facility Modifier None Typical Low $549.54 Median $562.34 Typical High $562.34 | Facility | None | $549.54 | $562.34 | $562.34 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 52 · Reduced service Typical Low $102.33 Median $141.25 Typical High $199.53 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 52 · Reduced service | $102.33 | $141.25 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $87.10 Median $107.15 Typical High $501.19 | Facility | None | $87.10 | $107.15 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $173.78 Typical High $251.19 | Professional | None | $151.36 | $173.78 | $251.19 |
United Setting Facility Modifier None Typical Low $309.03 Median $616.60 Typical High $2,511.89 | Facility | None | $309.03 | $616.60 | $2,511.89 |
United Setting Professional Modifier None Typical Low $117.49 Median $162.18 Typical High $223.87 | Professional | None | $117.49 | $162.18 | $223.87 |
5 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 $112.20 Median $112.20 Typical High $141.25 | Professional | 52 · Reduced service | $112.20 | $112.20 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $44.67 Typical High $56.23 | Professional | 53 · Discontinued | $44.67 | $44.67 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $165.96 Typical High $208.93 | Professional | 54 · Surgery only | $165.96 | $165.96 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $33.88 Typical High $42.66 | Professional | 55 · Aftercare only | $33.88 | $33.88 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $22.39 Typical High $28.18 | Professional | 56 · Pre-op care only | $22.39 | $22.39 | $28.18 |
Where Alabama sits
The same service costs 3.4 times more in Alaska than in Pennsylvania. 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· 30th of 51
$224
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.