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 $1,348.96 Median $2,137.96 Typical High $2,137.96 | Professional | None | $1,348.96 | $2,137.96 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Facility | None | $1,174.90 | $1,174.90 | $1,174.90 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,174.90 | Professional | None | $851.14 | $851.14 | $1,174.90 |
United Setting Facility Modifier None Typical Low $870.96 Median $2,187.76 Typical High $2,570.40 | Facility | None | $870.96 | $2,187.76 | $2,570.40 |
United Setting Professional Modifier None Typical Low $630.96 Median $1,047.13 Typical High $1,348.96 | Professional | None | $630.96 | $1,047.13 | $1,348.96 |
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 $676.08 Median $1,071.52 Typical High $1,071.52 | Professional | 52 · Reduced service | $676.08 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $426.58 Typical High $426.58 | Professional | 53 · Discontinued | $269.15 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $323.59 Typical High $323.59 | Professional | 55 · Aftercare only | $199.53 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $213.80 Typical High $213.80 | Professional | 56 · Pre-op care only | $134.90 | $213.80 | $213.80 |
BCBS Alabama Setting Professional Modifier 12 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 55 · Aftercare only + 99 · Multiple modifiers Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Professional | 12 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 55 · Aftercare only + 99 · Multiple modifiers | $1,698.24 | $1,698.24 | $1,698.24 |
Where Alabama sits
The same service costs 3.0 times more in Montana 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· 37th of 51
$1,122
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.