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 $371.54 Median $549.54 Typical High $549.54 | Professional | None | $371.54 | $549.54 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $380.19 Typical High $416.87 | Facility | None | $380.19 | $380.19 | $416.87 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $380.19 | Professional | None | $275.42 | $275.42 | $380.19 |
United Setting Facility Modifier None Typical Low $389.05 Median $676.08 Typical High $794.33 | Facility | None | $389.05 | $676.08 | $794.33 |
United Setting Professional Modifier None Typical Low $194.98 Median $275.42 Typical High $416.87 | Professional | None | $194.98 | $275.42 | $416.87 |
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 $199.53 Median $275.42 Typical High $275.42 | Professional | 52 · Reduced service | $199.53 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $109.65 Typical High $109.65 | Professional | 53 · Discontinued | $79.43 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $81.28 Typical High $81.28 | Professional | 55 · Aftercare only | $60.26 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $54.95 Typical High $54.95 | Professional | 56 · Pre-op care only | $39.81 | $54.95 | $54.95 |
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 $457.09 Median $457.09 Typical High $457.09 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $457.09 | $457.09 | $457.09 |
Where Alabama sits
The same service costs 3.7 times more in Hawaii than in Florida. 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· 49th of 51
$288
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.