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 $1,548.82 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,548.82 | $1,548.82 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Facility | None | $1,412.54 | $1,412.54 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,412.54 | Professional | None | $1,023.29 | $1,023.29 | $1,412.54 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $2,137.96 Typical High $2,511.89 | Facility | None | $1,230.27 | $2,137.96 | $2,511.89 |
United Setting Professional Modifier None Typical Low $616.60 Median $912.01 Typical High $1,380.38 | Professional | None | $616.60 | $912.01 | $1,380.38 |
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 $776.25 Median $776.25 Typical High $776.25 | Professional | 52 · Reduced service | $776.25 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | 53 · Discontinued | $309.03 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | 55 · Aftercare only | $234.42 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | 56 · Pre-op care only | $154.88 | $154.88 | $154.88 |
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 $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $1,513.56 | $1,513.56 | $1,513.56 |
Where Alabama sits
The same service costs 3.6 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· 46th of 51
$1,023
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.