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 $194.98 Median $281.84 Typical High $281.84 | Professional | None | $194.98 | $281.84 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Facility | None | $218.78 | $218.78 | $218.78 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $218.78 | Professional | None | $158.49 | $158.49 | $218.78 |
United Setting Facility Modifier None Typical Low $199.53 Median $346.74 Typical High $407.38 | Facility | None | $199.53 | $346.74 | $407.38 |
United Setting Professional Modifier None Typical Low $100.00 Median $144.54 Typical High $213.80 | Professional | None | $100.00 | $144.54 | $213.80 |
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 $95.50 Median $141.25 Typical High $141.25 | Professional | 52 · Reduced service | $95.50 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $56.23 Typical High $56.23 | Professional | 53 · Discontinued | $38.90 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $42.66 Typical High $42.66 | Professional | 55 · Aftercare only | $28.84 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $28.18 Typical High $28.18 | Professional | 56 · Pre-op care only | $19.50 | $28.18 | $28.18 |
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 3.3 times more in Hawaii than in West Virginia. 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
$158
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.