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 $407.38 Median $660.69 Typical High $660.69 | Professional | None | $407.38 | $660.69 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Facility | None | $436.52 | $436.52 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $436.52 | Professional | None | $316.23 | $316.23 | $436.52 |
United Setting Facility Modifier None Typical Low $707.95 Median $851.14 Typical High $851.14 | Facility | None | $707.95 | $851.14 | $851.14 |
United Setting Professional Modifier None Typical Low $204.17 Median $331.13 Typical High $467.74 | Professional | None | $204.17 | $331.13 | $467.74 |
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 $204.17 Median $331.13 Typical High $331.13 | Professional | 52 · Reduced service | $204.17 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $131.83 Typical High $131.83 | Professional | 53 · Discontinued | $81.28 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $97.72 Typical High $97.72 | Professional | 55 · Aftercare only | $61.66 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $66.07 Typical High $66.07 | Professional | 56 · Pre-op care only | $40.74 | $66.07 | $66.07 |
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 $512.86 Median $512.86 Typical High $512.86 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $512.86 | $512.86 | $512.86 |
Where Alabama sits
The same service costs 2.3 times more in Montana 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· 44th of 51
$347
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.