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 $15,135.61 Median $15,135.61 Typical High $15,135.61 | Professional | None | $15,135.61 | $15,135.61 | $15,135.61 |
Cigna Setting Facility Modifier None Typical Low $12,589.25 Median $12,589.25 Typical High $12,589.25 | Facility | None | $12,589.25 | $12,589.25 | $12,589.25 |
Cigna Setting Professional Modifier None Typical Low $9,120.11 Median $9,120.11 Typical High $12,589.25 | Professional | None | $9,120.11 | $9,120.11 | $12,589.25 |
United Setting Facility Modifier None Typical Low $7,943.28 Median $20,417.38 Typical High $23,988.33 | Facility | None | $7,943.28 | $20,417.38 | $23,988.33 |
United Setting Professional Modifier None Typical Low $5,888.44 Median $8,912.51 Typical High $13,182.57 | Professional | None | $5,888.44 | $8,912.51 | $13,182.57 |
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 $7,585.78 Median $7,585.78 Typical High $7,585.78 | Professional | 52 · Reduced service | $7,585.78 | $7,585.78 | $7,585.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3,019.95 Median $3,019.95 Typical High $3,019.95 | Professional | 53 · Discontinued | $3,019.95 | $3,019.95 | $3,019.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Professional | 55 · Aftercare only | $2,290.87 | $2,290.87 | $2,290.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | 56 · Pre-op care only | $1,513.56 | $1,513.56 | $1,513.56 |
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 $13,489.63 Median $13,489.63 Typical High $13,489.63 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $13,489.63 | $13,489.63 | $13,489.63 |
Where Alabama sits
The same service costs 2.5 times more in Montana than in Florida. 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· 46th of 51
$9,550
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.