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 $660.69 Median $977.24 Typical High $977.24 | Professional | None | $660.69 | $977.24 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $616.60 Typical High $616.60 | Facility | None | $616.60 | $616.60 | $616.60 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $616.60 | Professional | None | $457.09 | $457.09 | $616.60 |
United Setting Facility Modifier None Typical Low $645.65 Median $1,148.15 Typical High $1,348.96 | Facility | None | $645.65 | $1,148.15 | $1,348.96 |
United Setting Professional Modifier None Typical Low $331.13 Median $501.19 Typical High $707.95 | Professional | None | $331.13 | $501.19 | $707.95 |
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 $363.08 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $363.08 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $144.54 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $147.91 Typical High $147.91 | Professional | 55 · Aftercare only | $109.65 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $72.44 | $97.72 | $97.72 |
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 $758.58 Median $758.58 Typical High $758.58 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $758.58 | $758.58 | $758.58 |
Where Alabama sits
The same service costs 3.6 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· 47th of 51
$525
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.