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 $58.88 Median $104.71 Typical High $141.25 | Professional | None | $58.88 | $104.71 | $141.25 |
Ambetter Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | None | $134.90 | $134.90 | $134.90 |
BCBS Setting Facility Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Facility | None | $239.88 | $239.88 | $239.88 |
BCBS Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 41 Typical Low $63.10 Median $85.11 Typical High $95.50 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 41 | $63.10 | $85.11 | $95.50 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $93.33 Typical High $446.68 | Facility | None | $50.12 | $93.33 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $107.15 Typical High $131.83 | Professional | None | $63.10 | $107.15 | $131.83 |
United Setting Facility Modifier None Typical Low $100.00 Median $363.08 Typical High $1,380.38 | Facility | None | $100.00 | $363.08 | $1,380.38 |
United Setting Professional Modifier None Typical Low $53.70 Median $102.33 Typical High $141.25 | Professional | None | $53.70 | $102.33 | $141.25 |
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 $29.51 Median $56.23 Typical High $63.10 | Professional | 52 · Reduced service | $29.51 | $56.23 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $22.39 Typical High $25.12 | Professional | 53 · Discontinued | $12.02 | $22.39 | $25.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $44.67 Median $83.18 Typical High $95.50 | Professional | 54 · Surgery only | $44.67 | $83.18 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $16.98 Typical High $19.05 | Professional | 55 · Aftercare only | $8.91 | $16.98 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $11.22 Typical High $12.59 | Professional | 56 · Pre-op care only | $6.03 | $11.22 | $12.59 |
Where Alabama sits
The same service costs 3.1 times more in Wisconsin than in Kentucky. 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· 17th of 51
$126
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.