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 $8,128.31 Median $9,120.11 Typical High $9,120.11 | Professional | None | $8,128.31 | $9,120.11 | $9,120.11 |
Cigna Setting Facility Modifier None Typical Low $7,585.78 Median $7,585.78 Typical High $7,585.78 | Facility | None | $7,585.78 | $7,585.78 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $5,495.41 Median $5,495.41 Typical High $7,585.78 | Professional | None | $5,495.41 | $5,495.41 | $7,585.78 |
United Setting Facility Modifier None Typical Low $4,265.80 Median $10,964.78 Typical High $12,882.50 | Facility | None | $4,265.80 | $10,964.78 | $12,882.50 |
United Setting Professional Modifier None Typical Low $3,162.28 Median $5,495.41 Typical High $7,079.46 | Professional | None | $3,162.28 | $5,495.41 | $7,079.46 |
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 $4,570.88 Median $4,570.88 Typical High $4,570.88 | Professional | 52 · Reduced service | $4,570.88 | $4,570.88 | $4,570.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Professional | 53 · Discontinued | $1,819.70 | $1,819.70 | $1,819.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | 55 · Aftercare only | $1,380.38 | $1,380.38 | $1,380.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $912.01 Median $912.01 Typical High $912.01 | Professional | 56 · Pre-op care only | $912.01 | $912.01 | $912.01 |
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 $8,912.51 Median $8,912.51 Typical High $8,912.51 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $8,912.51 | $8,912.51 | $8,912.51 |
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· 39th of 51
$5,754
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.