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 $436.52 Median $467.74 Typical High $467.74 | Professional | None | $436.52 | $467.74 | $467.74 |
BCBS Alabama Setting Facility Modifier None Typical Low $6,760.83 Median $6,760.83 Typical High $6,760.83 | Facility | None | $6,760.83 | $6,760.83 | $6,760.83 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery Typical Low $302.00 Median $416.87 Typical High $537.03 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery | $302.00 | $416.87 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $3,548.13 Typical High $4,365.16 | Facility | None | $549.54 | $3,548.13 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | None | $331.13 | $331.13 | $331.13 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $3,801.89 Typical High $8,511.38 | Facility | None | $1,513.56 | $3,801.89 | $8,511.38 |
United Setting Professional Modifier None Typical Low $281.84 Median $371.54 Typical High $537.03 | Professional | None | $281.84 | $371.54 | $537.03 |
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 $218.78 Median $234.42 Typical High $234.42 | Professional | 52 · Reduced service | $218.78 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $93.33 Typical High $93.33 | Professional | 53 · Discontinued | $87.10 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | 54 · Surgery only | $346.74 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $69.18 Typical High $69.18 | Professional | 55 · Aftercare only | $64.57 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $46.77 Typical High $46.77 | Professional | 56 · Pre-op care only | $43.65 | $46.77 | $46.77 |
Where Alabama sits
The same service costs 4.5 times more in Alaska than in New York. 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· 25th of 51
$468
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.