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 $380.19 Median $588.84 Typical High $588.84 | Professional | None | $380.19 | $588.84 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Facility | None | $416.87 | $416.87 | $416.87 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $416.87 | Professional | None | $309.03 | $309.03 | $416.87 |
United Setting Facility Modifier None Typical Low $363.08 Median $645.65 Typical High $758.58 | Facility | None | $363.08 | $645.65 | $758.58 |
United Setting Professional Modifier None Typical Low $186.21 Median $295.12 Typical High $398.11 | Professional | None | $186.21 | $295.12 | $398.11 |
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 $190.55 Median $295.12 Typical High $295.12 | Professional | 52 · Reduced service | $190.55 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $120.23 Typical High $120.23 | Professional | 53 · Discontinued | $75.86 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $89.13 Typical High $89.13 | Professional | 55 · Aftercare only | $56.23 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $58.88 Typical High $58.88 | Professional | 56 · Pre-op care only | $38.02 | $58.88 | $58.88 |
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 $512.86 Median $512.86 Typical High $512.86 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $512.86 | $512.86 | $512.86 |
Where Alabama sits
The same service costs 2.9 times more in Hawaii than in Washington, DC. 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· 43rd of 51
$316
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.