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 Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $257.04 | Professional | None | $229.09 | $229.09 | $257.04 |
BCBS Alabama Setting Facility Modifier None Typical Low $158.49 Median $162.18 Typical High $162.18 | Facility | None | $158.49 | $162.18 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $251.19 Median $263.03 Typical High $331.13 | Facility | None | $251.19 | $263.03 | $331.13 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $251.19 Typical High $251.19 | Professional | None | $199.53 | $251.19 | $251.19 |
United Setting Professional Modifier None Typical Low $223.87 Median $257.04 Typical High $269.15 | Professional | None | $223.87 | $257.04 | $269.15 |
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 $114.82 Median $114.82 Typical High $114.82 | Professional | 52 · Reduced service | $114.82 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | 53 · Discontinued | $45.71 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | 55 · Aftercare only | $34.67 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $22.91 Typical High $22.91 | Professional | 56 · Pre-op care only | $22.91 | $22.91 | $22.91 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 52 · Reduced service Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 52 · Reduced service | $223.87 | $223.87 | $223.87 |
Where Alabama sits
The same service costs 2.0 times more in Arizona than in Alabama. 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· 51st of 51
$162
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.