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 $6,760.83 Median $7,585.78 Typical High $7,585.78 | Professional | None | $6,760.83 | $7,585.78 | $7,585.78 |
Cigna Setting Facility Modifier None Typical Low $4,677.35 Median $4,677.35 Typical High $4,677.35 | Facility | None | $4,677.35 | $4,677.35 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $4,677.35 | Professional | None | $3,467.37 | $3,467.37 | $4,677.35 |
United Setting Facility Modifier None Typical Low $2,884.03 Median $8,128.31 Typical High $9,549.93 | Facility | None | $2,884.03 | $8,128.31 | $9,549.93 |
United Setting Professional Modifier None Typical Low $2,344.23 Median $4,466.84 Typical High $5,370.32 | Professional | None | $2,344.23 | $4,466.84 | $5,370.32 |
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 $3,311.31 Median $3,715.35 Typical High $3,715.35 | Professional | 52 · Reduced service | $3,311.31 | $3,715.35 | $3,715.35 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,348.96 Median $1,513.56 Typical High $1,513.56 | Professional | 53 · Discontinued | $1,348.96 | $1,513.56 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1,000.00 Median $1,122.02 Typical High $1,122.02 | Professional | 55 · Aftercare only | $1,000.00 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $676.08 Median $758.58 Typical High $758.58 | Professional | 56 · Pre-op care only | $676.08 | $758.58 | $758.58 |
BCBS Setting Professional Modifier 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 Typical Low $6,606.93 Median $6,606.93 Typical High $6,606.93 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $6,606.93 | $6,606.93 | $6,606.93 |
Where Alabama sits
The same service costs 2.3 times more in Arkansas 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· 24th of 51
$4,677
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.