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 $17.78 Median $17.78 Typical High $23.44 | Facility | None | $17.78 | $17.78 | $23.44 |
Aetna Setting Professional Modifier None Typical Low $12.30 Median $17.78 Typical High $17.78 | Professional | None | $12.30 | $17.78 | $17.78 |
BCBS Setting Facility Modifier None Typical Low $15.14 Median $15.14 Typical High $15.14 | Facility | None | $15.14 | $15.14 | $15.14 |
BCBS Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers Typical Low $10.72 Median $12.88 Typical High $15.49 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $10.72 | $12.88 | $15.49 |
Cigna Setting Facility Modifier None Typical Low $12.30 Median $12.88 Typical High $47.86 | Facility | None | $12.30 | $12.88 | $47.86 |
Cigna Setting Professional Modifier None Typical Low $7.76 Median $9.55 Typical High $87.10 | Professional | None | $7.76 | $9.55 | $87.10 |
United Setting Facility Modifier None Typical Low $5.50 Median $13.80 Typical High $15.14 | Facility | None | $5.50 | $13.80 | $15.14 |
United Setting Professional Modifier None Typical Low $6.46 Median $7.59 Typical High $12.59 | Professional | None | $6.46 | $7.59 | $12.59 |
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 $6.76 Median $8.71 Typical High $8.71 | Professional | 52 · Reduced service | $6.76 | $8.71 | $8.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.69 Median $3.55 Typical High $3.55 | Professional | 53 · Discontinued | $2.69 | $3.55 | $3.55 |
Where Alabama sits
The same service costs 3.9 times more in Kansas than in Nebraska. 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
$15.14
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.