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 $1,174.90 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,174.90 | $1,737.80 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Facility | None | $1,380.38 | $1,380.38 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,380.38 | Professional | None | $1,023.29 | $1,023.29 | $1,380.38 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $2,041.74 Typical High $2,398.83 | Facility | None | $1,000.00 | $2,041.74 | $2,398.83 |
United Setting Professional Modifier None Typical Low $588.84 Median $891.25 Typical High $1,288.25 | Professional | None | $588.84 | $891.25 | $1,288.25 |
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 $588.84 Median $870.96 Typical High $870.96 | Professional | 52 · Reduced service | $588.84 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $346.74 Typical High $346.74 | Professional | 53 · Discontinued | $234.42 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $263.03 Typical High $263.03 | Professional | 55 · Aftercare only | $173.78 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $173.78 Typical High $173.78 | Professional | 56 · Pre-op care only | $117.49 | $173.78 | $173.78 |
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 $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $1,380.38 | $1,380.38 | $1,380.38 |
Where Alabama sits
The same service costs 2.7 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· 47th of 51
$1,023
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.