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 $1,023.29 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,023.29 | $1,621.81 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $891.25 | Professional | None | $645.65 | $645.65 | $891.25 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,659.59 Typical High $1,949.84 | Facility | None | $707.95 | $1,659.59 | $1,949.84 |
United Setting Professional Modifier None Typical Low $478.63 Median $794.33 Typical High $1,023.29 | Professional | None | $478.63 | $794.33 | $1,023.29 |
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 $512.86 Median $812.83 Typical High $812.83 | Professional | 52 · Reduced service | $512.86 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $323.59 Typical High $323.59 | Professional | 53 · Discontinued | $204.17 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $151.36 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $162.18 Typical High $162.18 | Professional | 56 · Pre-op care only | $102.33 | $162.18 | $162.18 |
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 $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $1,258.93 | $1,258.93 | $1,258.93 |
Where Alabama sits
The same service costs 3.0 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· 37th of 51
$851
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.