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 $371.54 Median $588.84 Typical High $588.84 | Professional | None | $371.54 | $588.84 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Facility | None | $524.81 | $524.81 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $524.81 | Professional | None | $380.19 | $380.19 | $524.81 |
United Setting Facility Modifier None Typical Low $389.05 Median $724.44 Typical High $851.14 | Facility | None | $389.05 | $724.44 | $851.14 |
United Setting Professional Modifier None Typical Low $208.93 Median $295.12 Typical High $446.68 | Professional | None | $208.93 | $295.12 | $446.68 |
6 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 $199.53 Median $295.12 Typical High $295.12 | Professional | 52 · Reduced service | $199.53 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $117.49 Typical High $117.49 | Professional | 53 · Discontinued | $79.43 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $87.10 Typical High $87.10 | Professional | 55 · Aftercare only | $60.26 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $58.88 Typical High $58.88 | Professional | 56 · Pre-op care only | $39.81 | $58.88 | $58.88 |
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 $436.52 Median $436.52 Typical High $436.52 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $436.52 | $436.52 | $436.52 |
Cigna Setting Professional Modifier RR · Rental Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | RR · Rental | $52.48 | $52.48 | $52.48 |
Where Alabama sits
The same service costs 2.8 times more in Hawaii than in Maryland. 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
$380
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.