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 $588.84 Median $588.84 Typical High $588.84 | Professional | None | $588.84 | $588.84 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Facility | None | $501.19 | $501.19 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $501.19 | Professional | None | $363.08 | $363.08 | $501.19 |
United Setting Facility Modifier None Typical Low $426.58 Median $794.33 Typical High $933.25 | Facility | None | $426.58 | $794.33 | $933.25 |
United Setting Professional Modifier None Typical Low $229.09 Median $346.74 Typical High $524.81 | Professional | None | $229.09 | $346.74 | $524.81 |
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 $288.40 Median $288.40 Typical High $288.40 | Professional | 52 · Reduced service | $288.40 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | 53 · Discontinued | $117.49 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | 55 · Aftercare only | $87.10 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | 56 · Pre-op care only | $58.88 | $58.88 | $58.88 |
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 $512.86 Median $512.86 Typical High $512.86 | Professional | 12 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 55 · Aftercare only + 99 · Multiple modifiers | $512.86 | $512.86 | $512.86 |
Where Alabama sits
The same service costs 3.0 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· 43rd of 51
$389
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.