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 $275.42 Median $371.54 Typical High $371.54 | Professional | None | $275.42 | $371.54 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Facility | None | $245.47 | $245.47 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $245.47 | Professional | None | $177.83 | $177.83 | $245.47 |
United Setting Facility Modifier None Typical Low $147.91 Median $457.09 Typical High $537.03 | Facility | None | $147.91 | $457.09 | $537.03 |
United Setting Professional Modifier None Typical Low $131.83 Median $186.21 Typical High $281.84 | Professional | None | $131.83 | $186.21 | $281.84 |
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 $138.04 Median $186.21 Typical High $186.21 | Professional | 52 · Reduced service | $138.04 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $74.13 Typical High $74.13 | Professional | 53 · Discontinued | $54.95 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $54.95 Typical High $54.95 | Professional | 55 · Aftercare only | $41.69 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $37.15 Typical High $37.15 | Professional | 56 · Pre-op care only | $27.54 | $37.15 | $37.15 |
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 $323.59 Median $323.59 Typical High $323.59 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $323.59 | $323.59 | $323.59 |
Where Alabama sits
The same service costs 2.9 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· 48th of 51
$195
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.