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 $331.13 Median $338.84 Typical High $338.84 | Professional | None | $331.13 | $338.84 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Facility | None | $245.47 | $245.47 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $245.47 | Professional | None | $177.83 | $177.83 | $245.47 |
United Setting Facility Modifier None Typical Low $169.82 Median $389.05 Typical High $457.09 | Facility | None | $169.82 | $389.05 | $457.09 |
United Setting Professional Modifier None Typical Low $112.20 Median $199.53 Typical High $257.04 | Professional | None | $112.20 | $199.53 | $257.04 |
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 $165.96 Median $169.82 Typical High $169.82 | Professional | 52 · Reduced service | $165.96 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $67.61 Typical High $67.61 | Professional | 53 · Discontinued | $66.07 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $50.12 Typical High $50.12 | Professional | 55 · Aftercare only | $48.98 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $33.88 Typical High $33.88 | Professional | 56 · Pre-op care only | $33.11 | $33.88 | $33.88 |
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 $295.12 Median $295.12 Typical High $295.12 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $295.12 | $295.12 | $295.12 |
Where Alabama sits
The same service costs 2.3 times more in Wisconsin than in Colorado. 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· 35th of 51
$209
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.