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 $398.11 Median $630.96 Typical High $630.96 | Professional | None | $398.11 | $630.96 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Facility | None | $371.54 | $371.54 | $371.54 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $371.54 | Professional | None | $275.42 | $275.42 | $371.54 |
United Setting Facility Modifier None Typical Low $346.74 Median $602.56 Typical High $707.95 | Facility | None | $346.74 | $602.56 | $707.95 |
United Setting Professional Modifier None Typical Low $173.78 Median $295.12 Typical High $389.05 | Professional | None | $173.78 | $295.12 | $389.05 |
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 $199.53 Median $316.23 Typical High $316.23 | Professional | 52 · Reduced service | $199.53 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $128.82 Typical High $128.82 | Professional | 53 · Discontinued | $79.43 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $95.50 Typical High $95.50 | Professional | 55 · Aftercare only | $60.26 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $63.10 Typical High $63.10 | Professional | 56 · Pre-op care only | $39.81 | $63.10 | $63.10 |
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 $501.19 Median $501.19 Typical High $501.19 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $501.19 | $501.19 | $501.19 |
Where Alabama sits
The same service costs 4.5 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· 30th of 51
$331
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.