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 $141.25 Median $218.78 Typical High $218.78 | Professional | None | $141.25 | $218.78 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Facility | None | $165.96 | $165.96 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $165.96 | Professional | None | $120.23 | $120.23 | $165.96 |
United Setting Facility Modifier None Typical Low $154.88 Median $269.15 Typical High $316.23 | Facility | None | $154.88 | $269.15 | $316.23 |
United Setting Professional Modifier None Typical Low $77.62 Median $109.65 Typical High $165.96 | Professional | None | $77.62 | $109.65 | $165.96 |
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 $70.79 Median $109.65 Typical High $109.65 | Professional | 52 · Reduced service | $70.79 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $43.65 Typical High $43.65 | Professional | 53 · Discontinued | $28.18 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $32.36 Typical High $32.36 | Professional | 55 · Aftercare only | $20.89 | $32.36 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $21.88 Typical High $21.88 | Professional | 56 · Pre-op care only | $14.13 | $21.88 | $21.88 |
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 $173.78 Median $173.78 Typical High $173.78 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $173.78 | $173.78 | $173.78 |
Where Alabama sits
The same service costs 4.4 times more in Hawaii than in Florida. 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· 47th of 51
$120
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.