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 $20.42 Median $20.42 Typical High $27.54 | Facility | None | $20.42 | $20.42 | $27.54 |
Aetna Setting Professional Modifier None Typical Low $14.45 Median $20.42 Typical High $20.42 | Professional | None | $14.45 | $20.42 | $20.42 |
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 $4.37 Median $5.37 Typical High $11.48 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $4.37 | $5.37 | $11.48 |
Cigna Setting Facility Modifier None Typical Low $14.45 Median $15.14 Typical High $56.23 | Facility | None | $14.45 | $15.14 | $56.23 |
Cigna Setting Professional Modifier None Typical Low $7.59 Median $9.33 Typical High $85.11 | Professional | None | $7.59 | $9.33 | $85.11 |
United Setting Facility Modifier None Typical Low $6.46 Median $15.85 Typical High $17.78 | Facility | None | $6.46 | $15.85 | $17.78 |
United Setting Professional Modifier None Typical Low $4.07 Median $7.41 Typical High $10.72 | Professional | None | $4.07 | $7.41 | $10.72 |
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 $7.24 Median $10.23 Typical High $10.23 | Professional | 52 · Reduced service | $7.24 | $10.23 | $10.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.88 Median $4.07 Typical High $4.07 | Professional | 53 · Discontinued | $2.88 | $4.07 | $4.07 |
Where Alabama sits
The same service costs 3.8 times more in Kansas than in Texas. 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· 23rd of 51
$17.78
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.