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 $3,235.94 Median $3,235.94 Typical High $3,235.94 | Professional | None | $3,235.94 | $3,235.94 | $3,235.94 |
Cigna Setting Facility Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $2,951.21 | Facility | None | $2,951.21 | $2,951.21 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,951.21 | Professional | None | $2,187.76 | $2,187.76 | $2,951.21 |
United Setting Facility Modifier None Typical Low $2,041.74 Median $4,265.80 Typical High $5,011.87 | Facility | None | $2,041.74 | $4,265.80 | $5,011.87 |
United Setting Professional Modifier None Typical Low $1,230.27 Median $1,949.84 Typical High $2,754.23 | Professional | None | $1,230.27 | $1,949.84 | $2,754.23 |
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 $1,621.81 Median $1,621.81 Typical High $1,621.81 | Professional | 52 · Reduced service | $1,621.81 | $1,621.81 | $1,621.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | 53 · Discontinued | $660.69 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | 55 · Aftercare only | $489.78 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | 56 · Pre-op care only | $323.59 | $323.59 | $323.59 |
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 $2,884.03 Median $2,884.03 Typical High $2,884.03 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $2,884.03 | $2,884.03 | $2,884.03 |
Where Alabama sits
The same service costs 2.5 times more in Montana 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· 44th of 51
$2,188
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.