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 $2,754.23 Median $2,754.23 Typical High $2,754.23 | Professional | None | $2,754.23 | $2,754.23 | $2,754.23 |
Cigna Setting Facility Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $2,691.53 | Facility | None | $2,691.53 | $2,691.53 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $2,691.53 | Professional | None | $1,949.84 | $1,949.84 | $2,691.53 |
United Setting Facility Modifier None Typical Low $1,862.09 Median $3,801.89 Typical High $4,466.84 | Facility | None | $1,862.09 | $3,801.89 | $4,466.84 |
United Setting Professional Modifier None Typical Low $1,096.48 Median $1,621.81 Typical High $2,454.71 | Professional | None | $1,096.48 | $1,621.81 | $2,454.71 |
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 $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | 52 · Reduced service | $1,380.38 | $1,380.38 | $1,380.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | 53 · Discontinued | $549.54 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | 55 · Aftercare only | $416.87 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | 56 · Pre-op care only | $275.42 | $275.42 | $275.42 |
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 $2,691.53 Median $2,691.53 Typical High $2,691.53 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $2,691.53 | $2,691.53 | $2,691.53 |
Where Alabama sits
The same service costs 2.9 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· 43rd of 51
$1,950
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.