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 $1,000.00 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,000.00 | $1,584.89 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $933.25 Typical High $933.25 | Facility | None | $933.25 | $933.25 | $933.25 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $933.25 | Professional | None | $691.83 | $691.83 | $933.25 |
United Setting Facility Modifier None Typical Low $1,737.80 Median $2,041.74 Typical High $2,041.74 | Facility | None | $1,737.80 | $2,041.74 | $2,041.74 |
United Setting Professional Modifier None Typical Low $501.19 Median $776.25 Typical High $1,071.52 | Professional | None | $501.19 | $776.25 | $1,071.52 |
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 $501.19 Median $794.33 Typical High $794.33 | Professional | 52 · Reduced service | $501.19 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $316.23 Typical High $316.23 | Professional | 53 · Discontinued | $199.53 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $239.88 Typical High $239.88 | Professional | 55 · Aftercare only | $151.36 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $158.49 Typical High $158.49 | Professional | 56 · Pre-op care only | $100.00 | $158.49 | $158.49 |
BCBS Alabama Setting Professional Modifier 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $1,202.26 | $1,202.26 | $1,202.26 |
Where Alabama sits
The same service costs 2.6 times more in Hawaii than in Delaware. 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· 44th of 51
$851
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.