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 $1,698.24 Median $2,454.71 Typical High $2,454.71 | Professional | None | $1,698.24 | $2,454.71 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Facility | None | $1,698.24 | $1,698.24 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,698.24 | Professional | None | $1,230.27 | $1,230.27 | $1,698.24 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $2,630.27 Typical High $3,090.30 | Facility | None | $1,513.56 | $2,630.27 | $3,090.30 |
United Setting Professional Modifier None Typical Low $758.58 Median $1,202.26 Typical High $1,621.81 | Professional | None | $758.58 | $1,202.26 | $1,621.81 |
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 $851.14 Median $1,230.27 Typical High $1,230.27 | Professional | 52 · Reduced service | $851.14 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $489.78 Typical High $489.78 | Professional | 53 · Discontinued | $338.84 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $371.54 Typical High $371.54 | Professional | 55 · Aftercare only | $257.04 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $245.47 Typical High $245.47 | Professional | 56 · Pre-op care only | $169.82 | $245.47 | $245.47 |
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 $1,949.84 Median $1,949.84 Typical High $1,949.84 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $1,949.84 | $1,949.84 | $1,949.84 |
Where Alabama sits
The same service costs 2.8 times more in Hawaii than in Arizona. 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· 40th of 51
$1,288
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.