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 $14.45 Median $16.60 Typical High $22.39 | Facility | None | $14.45 | $16.60 | $22.39 |
Aetna Setting Professional Modifier None Typical Low $9.77 Median $16.60 Typical High $16.60 | Professional | None | $9.77 | $16.60 | $16.60 |
Ambetter Setting Professional Modifier None Typical Low $8.71 Median $10.00 Typical High $19.50 | Professional | None | $8.71 | $10.00 | $19.50 |
BCBS Setting Facility Modifier None Typical Low $17.78 Median $17.78 Typical High $17.78 | Facility | None | $17.78 | $17.78 | $17.78 |
BCBS Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers Typical Low $10.23 Median $12.30 Typical High $14.79 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $10.23 | $12.30 | $14.79 |
Cigna Setting Facility Modifier None Typical Low $11.75 Median $12.30 Typical High $46.77 | Facility | None | $11.75 | $12.30 | $46.77 |
Cigna Setting Professional Modifier None Typical Low $7.41 Median $9.12 Typical High $83.18 | Professional | None | $7.41 | $9.12 | $83.18 |
United Setting Facility Modifier None Typical Low $5.25 Median $13.18 Typical High $30.20 | Facility | None | $5.25 | $13.18 | $30.20 |
United Setting Professional Modifier None Typical Low $6.17 Median $8.32 Typical High $12.02 | Professional | None | $6.17 | $8.32 | $12.02 |
2 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 $6.46 Median $8.32 Typical High $8.32 | Professional | 52 · Reduced service | $6.46 | $8.32 | $8.32 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.57 Median $3.39 Typical High $3.39 | Professional | 53 · Discontinued | $2.57 | $3.39 | $3.39 |
Where Alabama sits
The same service costs 10.2 times more in Vermont than in Maryland. 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· 25th of 51
$16.60
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.