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 $912.01 Median $1,445.44 Typical High $1,445.44 | Professional | None | $912.01 | $1,445.44 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $851.14 Typical High $851.14 | Facility | None | $851.14 | $851.14 | $851.14 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $851.14 | Professional | None | $616.60 | $616.60 | $851.14 |
United Setting Facility Modifier None Typical Low $630.96 Median $1,548.82 Typical High $1,819.70 | Facility | None | $630.96 | $1,548.82 | $1,819.70 |
United Setting Professional Modifier None Typical Low $446.68 Median $707.95 Typical High $954.99 | Professional | None | $446.68 | $707.95 | $954.99 |
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 $457.09 Median $724.44 Typical High $724.44 | Professional | 52 · Reduced service | $457.09 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $288.40 Typical High $288.40 | Professional | 53 · Discontinued | $181.97 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $213.80 Typical High $213.80 | Professional | 55 · Aftercare only | $134.90 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $144.54 Typical High $144.54 | Professional | 56 · Pre-op care only | $91.20 | $144.54 | $144.54 |
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 $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $1,148.15 | $1,148.15 | $1,148.15 |
Where Alabama sits
The same service costs 3.0 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· 45th of 51
$759
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.