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 $1,258.93 Median $1,949.84 Typical High $1,949.84 | Professional | None | $1,258.93 | $1,949.84 | $1,949.84 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Facility | None | $1,318.26 | $1,318.26 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,318.26 | Professional | None | $954.99 | $954.99 | $1,318.26 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,398.83 Typical High $2,818.38 | Facility | None | $1,122.02 | $2,398.83 | $2,818.38 |
United Setting Professional Modifier None Typical Low $691.83 Median $1,000.00 Typical High $1,479.11 | Professional | None | $691.83 | $1,000.00 | $1,479.11 |
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 $676.08 Median $977.24 Typical High $977.24 | Professional | 52 · Reduced service | $676.08 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $389.05 Typical High $389.05 | Professional | 53 · Discontinued | $269.15 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $295.12 Typical High $295.12 | Professional | 55 · Aftercare only | $199.53 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $194.98 Typical High $194.98 | Professional | 56 · Pre-op care only | $134.90 | $194.98 | $194.98 |
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 $1,584.89 Median $1,584.89 Typical High $1,584.89 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $1,584.89 | $1,584.89 | $1,584.89 |
Where Alabama sits
The same service costs 2.9 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· 50th of 51
$1,047
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.