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 $776.25 Median $1,258.93 Typical High $2,630.27 | Facility | None | $776.25 | $1,258.93 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $72.44 Typical High $97.72 | Professional | None | $63.10 | $72.44 | $97.72 |
BCBS Setting Facility Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Facility | None | $288.40 | $288.40 | $288.40 |
BCBS Setting Professional Modifier 32 · Mandated service Typical Low $51.29 Median $70.79 Typical High $107.15 | Professional | 32 · Mandated service | $51.29 | $70.79 | $107.15 |
Cigna Setting Facility Modifier None Typical Low $33.88 Median $42.66 Typical High $446.68 | Facility | None | $33.88 | $42.66 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $69.18 Typical High $100.00 | Professional | None | $52.48 | $69.18 | $100.00 |
United Setting Facility Modifier None Typical Low $100.00 Median $363.08 Typical High $1,380.38 | Facility | None | $100.00 | $363.08 | $1,380.38 |
United Setting Professional Modifier None Typical Low $40.74 Median $60.26 Typical High $95.50 | Professional | None | $40.74 | $60.26 | $95.50 |
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 $31.62 Median $31.62 Typical High $48.98 | Professional | 52 · Reduced service | $31.62 | $31.62 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $12.59 Typical High $19.95 | Professional | 53 · Discontinued | $12.59 | $12.59 | $19.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $46.77 Median $46.77 Typical High $74.13 | Professional | 54 · Surgery only | $46.77 | $46.77 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $9.33 Typical High $14.79 | Professional | 55 · Aftercare only | $9.33 | $9.33 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $6.31 Typical High $9.77 | Professional | 56 · Pre-op care only | $6.31 | $6.31 | $9.77 |
Where Alabama sits
The same service costs 3.1 times more in Wisconsin than in Washington, DC. 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· 28th of 51
$81.28
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.