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 $575.44 Median $891.25 Typical High $891.25 | Professional | None | $575.44 | $891.25 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Facility | None | $489.78 | $489.78 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $489.78 | Professional | None | $363.08 | $363.08 | $489.78 |
United Setting Facility Modifier None Typical Low $478.63 Median $912.01 Typical High $1,071.52 | Facility | None | $478.63 | $912.01 | $1,071.52 |
United Setting Professional Modifier None Typical Low $263.03 Median $436.52 Typical High $562.34 | Professional | None | $263.03 | $436.52 | $562.34 |
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 $288.40 Median $446.68 Typical High $446.68 | Professional | 52 · Reduced service | $288.40 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $177.83 Typical High $177.83 | Professional | 53 · Discontinued | $114.82 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $134.90 Typical High $134.90 | Professional | 55 · Aftercare only | $87.10 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $89.13 Typical High $89.13 | Professional | 56 · Pre-op care only | $57.54 | $89.13 | $89.13 |
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 $707.95 Median $707.95 Typical High $707.95 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $707.95 | $707.95 | $707.95 |
Where Alabama sits
The same service costs 3.2 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
$468
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.