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 $2,187.76 Median $2,238.72 Typical High $2,238.72 | Professional | None | $2,187.76 | $2,238.72 | $2,238.72 |
Cigna Setting Facility Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Facility | None | $1,737.80 | $1,737.80 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,737.80 | Professional | None | $1,288.25 | $1,288.25 | $1,737.80 |
United Setting Facility Modifier None Typical Low $977.24 Median $2,630.27 Typical High $3,090.30 | Facility | None | $977.24 | $2,630.27 | $3,090.30 |
United Setting Professional Modifier None Typical Low $758.58 Median $1,318.26 Typical High $1,737.80 | Professional | None | $758.58 | $1,318.26 | $1,737.80 |
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 $1,096.48 Median $1,122.02 Typical High $1,122.02 | Professional | 52 · Reduced service | $1,096.48 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $436.52 Median $446.68 Typical High $446.68 | Professional | 53 · Discontinued | $436.52 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $331.13 Median $338.84 Typical High $338.84 | Professional | 55 · Aftercare only | $331.13 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $218.78 Median $223.87 Typical High $223.87 | Professional | 56 · Pre-op care only | $218.78 | $223.87 | $223.87 |
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 $1,995.26 Median $1,995.26 Typical High $1,995.26 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $1,995.26 | $1,995.26 | $1,995.26 |
Where Alabama sits
The same service costs 2.1 times more in Montana than in Pennsylvania. 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· 30th of 51
$1,413
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.