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 $2,691.53 Typical High $2,691.53 | Professional | None | $1,698.24 | $2,691.53 | $2,691.53 |
Cigna Setting Facility Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Facility | None | $1,548.82 | $1,548.82 | $1,548.82 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,548.82 | Professional | None | $1,122.02 | $1,122.02 | $1,548.82 |
United Setting Facility Modifier None Typical Low $1,584.89 Median $2,691.53 Typical High $3,235.94 | Facility | None | $1,584.89 | $2,691.53 | $3,235.94 |
United Setting Professional Modifier None Typical Low $776.25 Median $1,318.26 Typical High $1,698.24 | Professional | None | $776.25 | $1,318.26 | $1,698.24 |
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 $831.76 Median $1,348.96 Typical High $1,348.96 | Professional | 52 · Reduced service | $831.76 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $537.03 Typical High $537.03 | Professional | 53 · Discontinued | $338.84 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $398.11 Typical High $398.11 | Professional | 55 · Aftercare only | $251.19 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $269.15 Typical High $269.15 | Professional | 56 · Pre-op care only | $169.82 | $269.15 | $269.15 |
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 $2,137.96 Median $2,137.96 Typical High $2,137.96 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $2,137.96 | $2,137.96 | $2,137.96 |
Where Alabama sits
The same service costs 3.1 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· 38th of 51
$1,413
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.