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 $239.88 Median $354.81 Typical High $354.81 | Professional | None | $239.88 | $354.81 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Facility | None | $234.42 | $234.42 | $234.42 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $234.42 | Professional | None | $173.78 | $173.78 | $234.42 |
United Setting Facility Modifier None Typical Low $251.19 Median $436.52 Typical High $512.86 | Facility | None | $251.19 | $436.52 | $512.86 |
United Setting Professional Modifier None Typical Low $125.89 Median $181.97 Typical High $269.15 | Professional | None | $125.89 | $181.97 | $269.15 |
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 $120.23 Median $177.83 Typical High $177.83 | Professional | 52 · Reduced service | $120.23 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $70.79 Typical High $70.79 | Professional | 53 · Discontinued | $48.98 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $53.70 Typical High $53.70 | Professional | 55 · Aftercare only | $36.31 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $35.48 Typical High $35.48 | Professional | 56 · Pre-op care only | $23.99 | $35.48 | $35.48 |
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 $275.42 Median $275.42 Typical High $275.42 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $275.42 | $275.42 | $275.42 |
Where Alabama sits
The same service costs 5.5 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· 48th of 51
$191
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.