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 $467.74 Median $676.08 Typical High $676.08 | Professional | None | $467.74 | $676.08 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $707.95 | Facility | None | $630.96 | $630.96 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $630.96 | Professional | None | $467.74 | $467.74 | $630.96 |
United Setting Facility Modifier None Typical Low $812.83 Median $954.99 Typical High $954.99 | Facility | None | $812.83 | $954.99 | $954.99 |
United Setting Professional Modifier None Typical Low $323.59 Median $524.81 Typical High $741.31 | Professional | None | $323.59 | $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 $263.03 Median $338.84 Typical High $338.84 | Professional | 52 · Reduced service | $263.03 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $134.90 Typical High $134.90 | Professional | 53 · Discontinued | $104.71 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $100.00 Typical High $100.00 | Professional | 55 · Aftercare only | $77.62 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $67.61 Typical High $67.61 | Professional | 56 · Pre-op care only | $52.48 | $67.61 | $67.61 |
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 $776.25 Median $776.25 Typical High $776.25 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $776.25 | $776.25 | $776.25 |
Where Alabama sits
The same service costs 2.2 times more in Kansas than in Utah. 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· 39th 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.