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 $724.44 Median $724.44 Typical High $724.44 | Professional | None | $724.44 | $724.44 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $588.84 Typical High $588.84 | Facility | None | $588.84 | $588.84 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $588.84 | Professional | None | $426.58 | $426.58 | $588.84 |
United Setting Facility Modifier None Typical Low $501.19 Median $1,000.00 Typical High $1,174.90 | Facility | None | $501.19 | $1,000.00 | $1,174.90 |
United Setting Professional Modifier None Typical Low $288.40 Median $426.58 Typical High $645.65 | Professional | None | $288.40 | $426.58 | $645.65 |
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 $363.08 Median $363.08 Typical High $363.08 | Professional | 52 · Reduced service | $363.08 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | 53 · Discontinued | $144.54 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | 55 · Aftercare only | $109.65 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | 56 · Pre-op care only | $72.44 | $72.44 | $72.44 |
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 $645.65 Median $645.65 Typical High $645.65 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $645.65 | $645.65 | $645.65 |
Where Alabama sits
The same service costs 2.8 times more in Hawaii than in West Virginia. 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
$479
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.