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 $758.58 Median $1,348.96 Typical High $1,348.96 | Professional | None | $758.58 | $1,348.96 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $831.76 Typical High $831.76 | Facility | None | $831.76 | $831.76 | $831.76 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $831.76 | Professional | None | $616.60 | $616.60 | $831.76 |
United Setting Facility Modifier None Typical Low $630.96 Median $1,445.44 Typical High $1,698.24 | Facility | None | $630.96 | $1,445.44 | $1,698.24 |
United Setting Professional Modifier None Typical Low $416.87 Median $660.69 Typical High $891.25 | Professional | None | $416.87 | $660.69 | $891.25 |
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 $426.58 Median $676.08 Typical High $676.08 | Professional | 52 · Reduced service | $426.58 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $269.15 Typical High $269.15 | Professional | 53 · Discontinued | $169.82 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $204.17 Typical High $204.17 | Professional | 55 · Aftercare only | $128.82 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $134.90 Typical High $134.90 | Professional | 56 · Pre-op care only | $85.11 | $134.90 | $134.90 |
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 $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $1,000.00 | $1,000.00 | $1,000.00 |
Where Alabama sits
The same service costs 3.2 times more in Hawaii than in Delaware. 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· 42nd of 51
$724
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.