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 Facility Modifier None Typical Low $562.34 Median $954.99 Typical High $2,398.83 | Facility | None | $562.34 | $954.99 | $2,398.83 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $89.13 Typical High $93.33 | Professional | None | $52.48 | $89.13 | $93.33 |
Ambetter Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | None | $45.71 | $45.71 | $45.71 |
BCBS Setting Facility Modifier None Typical Low $912.01 Median $933.25 Typical High $933.25 | Facility | None | $912.01 | $933.25 | $933.25 |
BCBS Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers Typical Low $60.26 Median $83.18 Typical High $95.50 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $60.26 | $83.18 | $95.50 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $446.68 | Facility | None | $50.12 | $66.07 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $131.83 Typical High $204.17 | Professional | None | $77.62 | $131.83 | $204.17 |
United Setting Facility Modifier None Typical Low $100.00 Median $371.54 Typical High $1,380.38 | Facility | None | $100.00 | $371.54 | $1,380.38 |
United Setting Professional Modifier None Typical Low $46.77 Median $87.10 Typical High $162.18 | Professional | None | $46.77 | $87.10 | $162.18 |
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 $26.30 Median $41.69 Typical High $46.77 | Professional | 52 · Reduced service | $26.30 | $41.69 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $16.60 Typical High $18.62 | Professional | 53 · Discontinued | $10.47 | $16.60 | $18.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $39.81 Median $63.10 Typical High $70.79 | Professional | 54 · Surgery only | $39.81 | $63.10 | $70.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $12.59 Typical High $14.13 | Professional | 55 · Aftercare only | $7.94 | $12.59 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $8.32 Typical High $9.33 | Professional | 56 · Pre-op care only | $5.25 | $8.32 | $9.33 |
Where Alabama sits
The same service costs 2.8 times more in Alaska than in Kentucky. 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· 36th of 51
$105
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.