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 $1,698.24 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,698.24 | $1,698.24 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Facility | None | $1,258.93 | $1,258.93 | $1,258.93 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $1,258.93 | Professional | None | $933.25 | $933.25 | $1,258.93 |
United Setting Facility Modifier None Typical Low $1,348.96 Median $2,344.23 Typical High $2,754.23 | Facility | None | $1,348.96 | $2,344.23 | $2,754.23 |
United Setting Professional Modifier None Typical Low $676.08 Median $1,023.29 Typical High $1,513.56 | Professional | None | $676.08 | $1,023.29 | $1,513.56 |
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 $851.14 Median $851.14 Typical High $851.14 | Professional | 52 · Reduced service | $851.14 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | 53 · Discontinued | $338.84 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | 55 · Aftercare only | $257.04 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $169.82 | $169.82 | $169.82 |
BCBS Alabama Setting Professional Modifier 12 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 55 · Aftercare only + 99 · Multiple modifiers Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | 12 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 55 · Aftercare only + 99 · Multiple modifiers | $1,513.56 | $1,513.56 | $1,513.56 |
Where Alabama sits
The same service costs 3.8 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· 44th of 51
$1,148
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.