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 $33,113.11 Median $33,113.11 Typical High $33,113.11 | Professional | None | $33,113.11 | $33,113.11 | $33,113.11 |
Cigna Setting Facility Modifier None Typical Low $30,199.52 Median $30,199.52 Typical High $30,199.52 | Facility | None | $30,199.52 | $30,199.52 | $30,199.52 |
Cigna Setting Professional Modifier None Typical Low $22,387.21 Median $22,387.21 Typical High $30,199.52 | Professional | None | $22,387.21 | $22,387.21 | $30,199.52 |
United Setting Facility Modifier None Typical Low $45,708.82 Median $53,703.18 Typical High $53,703.18 | Facility | None | $45,708.82 | $53,703.18 | $53,703.18 |
United Setting Professional Modifier None Typical Low $13,182.57 Median $19,498.45 Typical High $29,512.09 | Professional | None | $13,182.57 | $19,498.45 | $29,512.09 |
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 $16,595.87 Median $16,595.87 Typical High $16,595.87 | Professional | 52 · Reduced service | $16,595.87 | $16,595.87 | $16,595.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6,606.93 Median $6,606.93 Typical High $6,606.93 | Professional | 53 · Discontinued | $6,606.93 | $6,606.93 | $6,606.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4,897.79 Median $4,897.79 Typical High $4,897.79 | Professional | 55 · Aftercare only | $4,897.79 | $4,897.79 | $4,897.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3,311.31 Median $3,311.31 Typical High $3,311.31 | Professional | 56 · Pre-op care only | $3,311.31 | $3,311.31 | $3,311.31 |
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 $32,359.37 Median $32,359.37 Typical High $32,359.37 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $32,359.37 | $32,359.37 | $32,359.37 |
Where Alabama sits
The same service costs 2.1 times more in Hawaii than in New Jersey. 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· 48th of 51
$22,387
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.