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 $245.47 Median $426.58 Typical High $426.58 | Professional | None | $245.47 | $426.58 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Facility | None | $218.78 | $218.78 | $218.78 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $218.78 | Professional | None | $158.49 | $158.49 | $218.78 |
United Setting Facility Modifier None Typical Low $36.31 Median $389.05 Typical High $457.09 | Facility | None | $36.31 | $389.05 | $457.09 |
United Setting Professional Modifier None Typical Low $112.20 Median $194.98 Typical High $257.04 | Professional | None | $112.20 | $194.98 | $257.04 |
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 $123.03 Median $213.80 Typical High $213.80 | Professional | 52 · Reduced service | $123.03 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $85.11 Typical High $85.11 | Professional | 53 · Discontinued | $48.98 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $63.10 Typical High $63.10 | Professional | 55 · Aftercare only | $37.15 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $42.66 Typical High $42.66 | Professional | 56 · Pre-op care only | $24.55 | $42.66 | $42.66 |
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 $331.13 Median $331.13 Typical High $331.13 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $331.13 | $331.13 | $331.13 |
Where Alabama sits
The same service costs 3.6 times more in Georgia than in Alaska. 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· 22nd of 51
$219
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.