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 $165.96 Median $257.04 Typical High $257.04 | Professional | None | $165.96 | $257.04 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Facility | None | $169.82 | $169.82 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $169.82 | Professional | None | $125.89 | $125.89 | $169.82 |
United Setting Facility Modifier None Typical Low $181.97 Median $316.23 Typical High $371.54 | Facility | None | $181.97 | $316.23 | $371.54 |
United Setting Professional Modifier None Typical Low $91.20 Median $131.83 Typical High $194.98 | Professional | None | $91.20 | $131.83 | $194.98 |
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 $81.28 Median $128.82 Typical High $128.82 | Professional | 52 · Reduced service | $81.28 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $51.29 Typical High $51.29 | Professional | 53 · Discontinued | $33.11 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $38.90 Typical High $38.90 | Professional | 55 · Aftercare only | $24.55 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $25.70 Typical High $25.70 | Professional | 56 · Pre-op care only | $16.60 | $25.70 | $25.70 |
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 $223.87 Median $223.87 Typical High $223.87 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $223.87 | $223.87 | $223.87 |
Where Alabama sits
The same service costs 4.7 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· 48th of 51
$138
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.