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 $10,715.19 Median $10,715.19 Typical High $10,715.19 | Professional | None | $10,715.19 | $10,715.19 | $10,715.19 |
Cigna Setting Facility Modifier None Typical Low $9,120.11 Median $9,120.11 Typical High $9,120.11 | Facility | None | $9,120.11 | $9,120.11 | $9,120.11 |
Cigna Setting Professional Modifier None Typical Low $6,606.93 Median $6,606.93 Typical High $9,120.11 | Professional | None | $6,606.93 | $6,606.93 | $9,120.11 |
United Setting Facility Modifier None Typical Low $5,128.61 Median $14,125.38 Typical High $16,595.87 | Facility | None | $5,128.61 | $14,125.38 | $16,595.87 |
United Setting Professional Modifier None Typical Low $4,073.80 Median $6,456.54 Typical High $9,120.11 | Professional | None | $4,073.80 | $6,456.54 | $9,120.11 |
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 $5,370.32 Median $5,370.32 Typical High $5,370.32 | Professional | 52 · Reduced service | $5,370.32 | $5,370.32 | $5,370.32 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2,137.96 Median $2,137.96 Typical High $2,137.96 | Professional | 53 · Discontinued | $2,137.96 | $2,137.96 | $2,137.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Professional | 55 · Aftercare only | $1,621.81 | $1,621.81 | $1,621.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | 56 · Pre-op care only | $1,071.52 | $1,071.52 | $1,071.52 |
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 $9,549.93 Median $9,549.93 Typical High $9,549.93 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $9,549.93 | $9,549.93 | $9,549.93 |
Where Alabama sits
The same service costs 2.5 times more in Montana than in Delaware. 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
$6,761
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.