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 $190.55 Median $245.47 Typical High $245.47 | Professional | None | $190.55 | $245.47 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Facility | None | $158.49 | $158.49 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $158.49 | Professional | None | $117.49 | $117.49 | $158.49 |
United Setting Facility Modifier None Typical Low $141.25 Median $295.12 Typical High $346.74 | Facility | None | $141.25 | $295.12 | $346.74 |
United Setting Professional Modifier None Typical Low $85.11 Median $123.03 Typical High $181.97 | Professional | None | $85.11 | $123.03 | $181.97 |
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 $95.50 Median $123.03 Typical High $123.03 | Professional | 52 · Reduced service | $95.50 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $48.98 Typical High $48.98 | Professional | 53 · Discontinued | $38.02 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $36.31 Typical High $36.31 | Professional | 55 · Aftercare only | $28.84 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $24.55 Typical High $24.55 | Professional | 56 · Pre-op care only | $19.05 | $24.55 | $24.55 |
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 $213.80 Median $213.80 Typical High $213.80 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $213.80 | $213.80 | $213.80 |
Where Alabama sits
The same service costs 4.4 times more in Hawaii than in Kansas. 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· 48th of 51
$129
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.