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 $891.25 Median $1,202.26 Typical High $1,202.26 | Professional | None | $891.25 | $1,202.26 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Facility | None | $1,047.13 | $1,047.13 | $1,047.13 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $1,047.13 | Professional | None | $776.25 | $776.25 | $1,047.13 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,479.11 Typical High $1,737.80 | Facility | None | $851.14 | $1,479.11 | $1,737.80 |
United Setting Professional Modifier None Typical Low $426.58 Median $602.56 Typical High $912.01 | Professional | None | $426.58 | $602.56 | $912.01 |
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 $446.68 Median $602.56 Typical High $602.56 | Professional | 52 · Reduced service | $446.68 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $239.88 Typical High $239.88 | Professional | 53 · Discontinued | $177.83 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $181.97 Typical High $181.97 | Professional | 55 · Aftercare only | $134.90 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $120.23 Typical High $120.23 | Professional | 56 · Pre-op care only | $89.13 | $120.23 | $120.23 |
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 $954.99 Median $954.99 Typical High $954.99 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $954.99 | $954.99 | $954.99 |
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· 37th of 51
$776
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.