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 $3,801.89 Median $3,801.89 Typical High $3,801.89 | Professional | None | $3,801.89 | $3,801.89 | $3,801.89 |
Cigna Setting Facility Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $2,884.03 | Facility | None | $2,884.03 | $2,884.03 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,884.03 | Professional | None | $2,089.30 | $2,089.30 | $2,884.03 |
United Setting Facility Modifier None Typical Low $3,019.95 Median $5,248.07 Typical High $6,165.95 | Facility | None | $3,019.95 | $5,248.07 | $6,165.95 |
United Setting Professional Modifier None Typical Low $1,513.56 Median $2,290.87 Typical High $3,467.37 | Professional | None | $1,513.56 | $2,290.87 | $3,467.37 |
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 $1,905.46 Median $1,905.46 Typical High $1,905.46 | Professional | 52 · Reduced service | $1,905.46 | $1,905.46 | $1,905.46 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | 53 · Discontinued | $758.58 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $575.44 Median $575.44 Typical High $575.44 | Professional | 55 · Aftercare only | $575.44 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | 56 · Pre-op care only | $380.19 | $380.19 | $380.19 |
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 $3,388.44 Median $3,388.44 Typical High $3,388.44 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $3,388.44 | $3,388.44 | $3,388.44 |
Where Alabama sits
The same service costs 3.4 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· 43rd of 51
$2,512
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.