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 $177.83 Median $275.42 Typical High $275.42 | Professional | None | $177.83 | $275.42 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Facility | None | $190.55 | $190.55 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $190.55 | Professional | None | $138.04 | $138.04 | $190.55 |
United Setting Facility Modifier None Typical Low $190.55 Median $338.84 Typical High $398.11 | Facility | None | $190.55 | $338.84 | $398.11 |
United Setting Professional Modifier None Typical Low $97.72 Median $141.25 Typical High $208.93 | Professional | None | $97.72 | $141.25 | $208.93 |
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 $93.33 Median $138.04 Typical High $138.04 | Professional | 52 · Reduced service | $93.33 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $54.95 Typical High $54.95 | Professional | 53 · Discontinued | $38.02 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $41.69 Typical High $41.69 | Professional | 55 · Aftercare only | $28.18 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $27.54 Typical High $27.54 | Professional | 56 · Pre-op care only | $19.05 | $27.54 | $27.54 |
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 $199.53 Median $199.53 Typical High $199.53 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $199.53 | $199.53 | $199.53 |
Where Alabama sits
The same service costs 3.5 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· 48th of 51
$148
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.