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 $1,584.89 Median $2,290.87 Typical High $2,290.87 | Professional | None | $1,584.89 | $2,290.87 | $2,290.87 |
Cigna Setting Facility Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Facility | None | $1,621.81 | $1,621.81 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,621.81 | Professional | None | $1,202.26 | $1,202.26 | $1,621.81 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $2,818.38 Typical High $3,311.31 | Facility | None | $1,479.11 | $2,818.38 | $3,311.31 |
United Setting Professional Modifier None Typical Low $812.83 Median $1,174.90 Typical High $1,737.80 | Professional | None | $812.83 | $1,174.90 | $1,737.80 |
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 $794.33 Median $1,148.15 Typical High $1,148.15 | Professional | 52 · Reduced service | $794.33 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $457.09 Typical High $457.09 | Professional | 53 · Discontinued | $316.23 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $346.74 Typical High $346.74 | Professional | 55 · Aftercare only | $239.88 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $229.09 Typical High $229.09 | Professional | 56 · Pre-op care only | $158.49 | $229.09 | $229.09 |
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 $1,819.70 Median $1,819.70 Typical High $1,819.70 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $1,819.70 | $1,819.70 | $1,819.70 |
Where Alabama sits
The same service costs 2.7 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· 47th of 51
$1,230
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.