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 $660.69 Median $1,071.52 Typical High $1,071.52 | Professional | None | $660.69 | $1,071.52 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $741.31 Typical High $741.31 | Facility | None | $741.31 | $741.31 | $741.31 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $741.31 | Professional | None | $537.03 | $537.03 | $741.31 |
United Setting Facility Modifier None Typical Low $645.65 Median $1,202.26 Typical High $1,412.54 | Facility | None | $645.65 | $1,202.26 | $1,412.54 |
United Setting Professional Modifier None Typical Low $346.74 Median $524.81 Typical High $741.31 | Professional | None | $346.74 | $524.81 | $741.31 |
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 $331.13 Median $524.81 Typical High $524.81 | Professional | 52 · Reduced service | $331.13 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $213.80 Typical High $213.80 | Professional | 53 · Discontinued | $131.83 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $158.49 Typical High $158.49 | Professional | 55 · Aftercare only | $100.00 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $107.15 Typical High $107.15 | Professional | 56 · Pre-op care only | $66.07 | $107.15 | $107.15 |
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 $741.31 Median $741.31 Typical High $741.31 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $741.31 | $741.31 | $741.31 |
Where Alabama sits
The same service costs 3.0 times more in Hawaii than in Vermont. 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
$562
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.