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 $199.53 Median $323.59 Typical High $323.59 | Professional | None | $199.53 | $323.59 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Facility | None | $190.55 | $190.55 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $190.55 | Professional | None | $138.04 | $138.04 | $190.55 |
United Setting Facility Modifier None Typical Low $125.89 Median $354.81 Typical High $416.87 | Facility | None | $125.89 | $354.81 | $416.87 |
United Setting Professional Modifier None Typical Low $100.00 Median $158.49 Typical High $218.78 | Professional | None | $100.00 | $158.49 | $218.78 |
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 $100.00 Median $158.49 Typical High $158.49 | Professional | 52 · Reduced service | $100.00 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $64.57 Typical High $64.57 | Professional | 53 · Discontinued | $40.74 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $47.86 Typical High $47.86 | Professional | 55 · Aftercare only | $30.20 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $32.36 Typical High $32.36 | Professional | 56 · Pre-op care only | $19.95 | $32.36 | $32.36 |
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 $223.87 Median $223.87 Typical High $223.87 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $223.87 | $223.87 | $223.87 |
Where Alabama sits
The same service costs 2.7 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· 44th of 51
$170
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.