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 $5,248.07 Median $5,248.07 Typical High $5,248.07 | Professional | None | $5,248.07 | $5,248.07 | $5,248.07 |
Cigna Setting Facility Modifier None Typical Low $4,897.79 Median $4,897.79 Typical High $4,897.79 | Facility | None | $4,897.79 | $4,897.79 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $4,897.79 | Professional | None | $3,548.13 | $3,548.13 | $4,897.79 |
United Setting Facility Modifier None Typical Low $4,073.80 Median $7,079.46 Typical High $8,317.64 | Facility | None | $4,073.80 | $7,079.46 | $8,317.64 |
United Setting Professional Modifier None Typical Low $2,041.74 Median $3,090.30 Typical High $4,677.35 | Professional | None | $2,041.74 | $3,090.30 | $4,677.35 |
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 $2,630.27 Median $2,630.27 Typical High $2,630.27 | Professional | 52 · Reduced service | $2,630.27 | $2,630.27 | $2,630.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Professional | 53 · Discontinued | $1,047.13 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $776.25 Median $776.25 Typical High $776.25 | Professional | 55 · Aftercare only | $776.25 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | 56 · Pre-op care only | $524.81 | $524.81 | $524.81 |
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 $4,570.88 Median $4,570.88 Typical High $4,570.88 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $4,570.88 | $4,570.88 | $4,570.88 |
Where Alabama sits
The same service costs 3.5 times more in Hawaii than in Washington, DC. 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· 49th of 51
$3,548
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.