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 Facility Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Facility | None | $812.83 | $812.83 | $812.83 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $812.83 Typical High $812.83 | Professional | None | $512.86 | $812.83 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Facility | None | $501.19 | $501.19 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $501.19 | Professional | None | $363.08 | $363.08 | $501.19 |
United Setting Facility Modifier None Typical Low $537.03 Median $933.25 Typical High $1,096.48 | Facility | None | $537.03 | $933.25 | $1,096.48 |
United Setting Professional Modifier None Typical Low $269.15 Median $398.11 Typical High $575.44 | Professional | None | $269.15 | $398.11 | $575.44 |
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 $269.15 Median $407.38 Typical High $407.38 | Professional | 52 · Reduced service | $269.15 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $162.18 Typical High $162.18 | Professional | 53 · Discontinued | $107.15 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $120.23 Typical High $120.23 | Professional | 55 · Aftercare only | $81.28 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $81.28 Typical High $81.28 | Professional | 56 · Pre-op care only | $53.70 | $81.28 | $81.28 |
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 $524.81 Median $524.81 Typical High $524.81 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $524.81 | $524.81 | $524.81 |
Where Alabama sits
The same service costs 3.9 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· 49th of 51
$427
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.