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 $4,265.80 Median $4,265.80 Typical High $4,265.80 | Professional | None | $4,265.80 | $4,265.80 | $4,265.80 |
Cigna Setting Facility Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $3,548.13 | Facility | None | $3,548.13 | $3,548.13 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $3,548.13 | Professional | None | $2,630.27 | $2,630.27 | $3,548.13 |
United Setting Facility Modifier None Typical Low $3,235.94 Median $5,623.41 Typical High $6,606.93 | Facility | None | $3,235.94 | $5,623.41 | $6,606.93 |
United Setting Professional Modifier None Typical Low $1,621.81 Median $2,570.40 Typical High $3,630.78 | Professional | None | $1,621.81 | $2,570.40 | $3,630.78 |
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 $2,137.96 Median $2,137.96 Typical High $2,137.96 | Professional | 52 · Reduced service | $2,137.96 | $2,137.96 | $2,137.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | 53 · Discontinued | $851.14 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | 55 · Aftercare only | $645.65 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $426.58 Median $426.58 Typical High $426.58 | Professional | 56 · Pre-op care only | $426.58 | $426.58 | $426.58 |
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 $3,801.89 Median $3,801.89 Typical High $3,801.89 | Professional | 12 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 55 · Aftercare only + 99 · Multiple modifiers | $3,801.89 | $3,801.89 | $3,801.89 |
Where Alabama sits
The same service costs 4.3 times more in Hawaii than in Pennsylvania. 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· 40th of 51
$2,818
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.