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 $407.38 Median $602.56 Typical High $602.56 | Professional | None | $407.38 | $602.56 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Facility | None | $398.11 | $398.11 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $398.11 | Professional | None | $295.12 | $295.12 | $398.11 |
United Setting Facility Modifier None Typical Low $295.12 Median $741.31 Typical High $870.96 | Facility | None | $295.12 | $741.31 | $870.96 |
United Setting Professional Modifier None Typical Low $213.80 Median $302.00 Typical High $457.09 | Professional | None | $213.80 | $302.00 | $457.09 |
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 $204.17 Median $302.00 Typical High $302.00 | Professional | 52 · Reduced service | $204.17 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $120.23 Typical High $120.23 | Professional | 53 · Discontinued | $81.28 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $91.20 Typical High $91.20 | Professional | 55 · Aftercare only | $61.66 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $60.26 Typical High $60.26 | Professional | 56 · Pre-op care only | $40.74 | $60.26 | $60.26 |
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 $467.74 Median $467.74 Typical High $467.74 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $467.74 | $467.74 | $467.74 |
Where Alabama sits
The same service costs 3.0 times more in Montana 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
$316
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.