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 $630.96 Median $1,000.00 Typical High $1,000.00 | Professional | None | $630.96 | $1,000.00 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $562.34 Typical High $562.34 | Facility | None | $562.34 | $562.34 | $562.34 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $562.34 | Professional | None | $416.87 | $416.87 | $562.34 |
United Setting Facility Modifier None Typical Low $549.54 Median $1,000.00 Typical High $1,202.26 | Facility | None | $549.54 | $1,000.00 | $1,202.26 |
United Setting Professional Modifier None Typical Low $288.40 Median $489.78 Typical High $630.96 | Professional | None | $288.40 | $489.78 | $630.96 |
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 $316.23 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $316.23 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $204.17 Typical High $204.17 | Professional | 53 · Discontinued | $125.89 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $95.50 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $63.10 | $100.00 | $100.00 |
BCBS Alabama Setting Professional Modifier 12 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 55 · Aftercare only + 99 · Multiple modifiers Typical Low $776.25 Median $776.25 Typical High $776.25 | Professional | 12 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 55 · Aftercare only + 99 · Multiple modifiers | $776.25 | $776.25 | $776.25 |
Where Alabama sits
The same service costs 3.6 times more in Hawaii than in Kansas. 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· 34th of 51
$537
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.