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 $245.47 Median $398.11 Typical High $398.11 | Professional | None | $245.47 | $398.11 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Facility | None | $263.03 | $263.03 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $263.03 | Professional | None | $194.98 | $194.98 | $263.03 |
United Setting Facility Modifier None Typical Low $213.80 Median $478.63 Typical High $562.34 | Facility | None | $213.80 | $478.63 | $562.34 |
United Setting Professional Modifier None Typical Low $138.04 Median $199.53 Typical High $295.12 | Professional | None | $138.04 | $199.53 | $295.12 |
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 $134.90 Median $199.53 Typical High $199.53 | Professional | 52 · Reduced service | $134.90 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $79.43 Typical High $79.43 | Professional | 53 · Discontinued | $53.70 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $58.88 Typical High $58.88 | Professional | 55 · Aftercare only | $40.74 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $39.81 Typical High $39.81 | Professional | 56 · Pre-op care only | $26.92 | $39.81 | $39.81 |
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 $331.13 Median $331.13 Typical High $331.13 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $331.13 | $331.13 | $331.13 |
Where Alabama sits
The same service costs 4.7 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· 48th of 51
$209
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.