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 $346.74 Median $512.86 Typical High $512.86 | Professional | None | $346.74 | $512.86 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Facility | None | $338.84 | $338.84 | $338.84 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $338.84 | Professional | None | $245.47 | $245.47 | $338.84 |
United Setting Facility Modifier None Typical Low $354.81 Median $616.60 Typical High $724.44 | Facility | None | $354.81 | $616.60 | $724.44 |
United Setting Professional Modifier None Typical Low $177.83 Median $263.03 Typical High $380.19 | Professional | None | $177.83 | $263.03 | $380.19 |
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 $169.82 Median $257.04 Typical High $257.04 | Professional | 52 · Reduced service | $169.82 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $102.33 Typical High $102.33 | Professional | 53 · Discontinued | $69.18 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $77.62 Typical High $77.62 | Professional | 55 · Aftercare only | $51.29 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $51.29 Typical High $51.29 | Professional | 56 · Pre-op care only | $34.67 | $51.29 | $51.29 |
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 $446.68 Median $446.68 Typical High $446.68 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $446.68 | $446.68 | $446.68 |
Where Alabama sits
The same service costs 4.2 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· 47th of 51
$275
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.