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 $5,128.61 Median $5,128.61 Typical High $5,128.61 | Professional | None | $5,128.61 | $5,128.61 | $5,128.61 |
Cigna Setting Facility Modifier None Typical Low $4,677.35 Median $4,677.35 Typical High $4,677.35 | Facility | None | $4,677.35 | $4,677.35 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $4,677.35 | Professional | None | $3,467.37 | $3,467.37 | $4,677.35 |
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 $4,570.88 | Professional | None | $2,041.74 | $3,090.30 | $4,570.88 |
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 $2,570.40 Median $2,570.40 Typical High $2,570.40 | Professional | 52 · Reduced service | $2,570.40 | $2,570.40 | $2,570.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | 53 · Discontinued | $1,023.29 | $1,023.29 | $1,023.29 |
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 $512.86 Median $512.86 Typical High $512.86 | Professional | 56 · Pre-op care only | $512.86 | $512.86 | $512.86 |
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 3.9 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· 45th of 51
$3,467
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.