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 Professional Modifier None Typical Low $131.83 Median $204.17 Typical High $204.17 | Professional | None | $131.83 | $204.17 | $204.17 |
Aetna Setting Professional Modifier UE · Used equipment Typical Low $83.18 Median $151.36 Typical High $151.36 | Professional | UE · Used equipment | $83.18 | $151.36 | $151.36 |
BCBS Alabama Setting Professional Modifier 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 Typical Low $26.30 Median $26.30 Typical High $263.03 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $26.30 | $26.30 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Facility | None | $177.83 | $177.83 | $177.83 |
Cigna Setting Facility Modifier RR · Rental Typical Low $17.78 Median $17.78 Typical High $17.78 | Facility | RR · Rental | $17.78 | $17.78 | $17.78 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $177.83 Typical High $186.21 | Professional | None | $151.36 | $177.83 | $186.21 |
Cigna Setting Professional Modifier RR · Rental Typical Low $15.14 Median $17.78 Typical High $17.78 | Professional | RR · Rental | $15.14 | $17.78 | $17.78 |
Cigna Setting Professional Modifier UE · Used equipment Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | UE · Used equipment | $114.82 | $114.82 | $114.82 |
United Setting Professional Modifier None Typical Low $74.13 Median $123.03 Typical High $208.93 | Professional | None | $74.13 | $123.03 | $208.93 |
United Setting Professional Modifier RR · Rental Typical Low $8.91 Median $13.80 Typical High $20.89 | Professional | RR · Rental | $8.91 | $13.80 | $20.89 |
United Setting Professional Modifier UE · Used equipment Typical Low $54.95 Median $89.13 Typical High $147.91 | Professional | UE · Used equipment | $54.95 | $89.13 | $147.91 |
4 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 $85.11 Median $102.33 Typical High $102.33 | Professional | 52 · Reduced service | $85.11 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $40.74 Typical High $40.74 | Professional | 53 · Discontinued | $33.88 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $30.20 Typical High $30.20 | Professional | 55 · Aftercare only | $25.12 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | 56 · Pre-op care only | $20.42 | $20.42 | $20.42 |
Where Alabama sits
The same service costs 22.4 times more in Kansas than in Illinois. 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· 30th of 51
$178
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.