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 $31.62 Median $31.62 Typical High $31.62 | Facility | None | $31.62 | $31.62 | $31.62 |
Aetna Setting Professional Modifier None Typical Low $16.22 Median $31.62 Typical High $31.62 | Professional | None | $16.22 | $31.62 | $31.62 |
Ambetter Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | None | $25.70 | $25.70 | $25.70 |
Cigna Setting Facility Modifier None Typical Low $22.39 Median $22.39 Typical High $24.55 | Facility | None | $22.39 | $22.39 | $24.55 |
Cigna Setting Professional Modifier None Typical Low $16.22 Median $16.22 Typical High $22.39 | Professional | None | $16.22 | $16.22 | $22.39 |
United Setting Facility Modifier None Typical Low $19.95 Median $34.67 Typical High $40.74 | Facility | None | $19.95 | $34.67 | $40.74 |
United Setting Professional Modifier None Typical Low $10.00 Median $15.49 Typical High $21.38 | Professional | None | $10.00 | $15.49 | $21.38 |
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 $11.22 Median $15.85 Typical High $15.85 | Professional | 52 · Reduced service | $11.22 | $15.85 | $15.85 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.47 Median $6.31 Typical High $6.31 | Professional | 53 · Discontinued | $4.47 | $6.31 | $6.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.39 Median $4.79 Typical High $4.79 | Professional | 55 · Aftercare only | $3.39 | $4.79 | $4.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.24 Median $3.16 Typical High $3.16 | Professional | 56 · Pre-op care only | $2.24 | $3.16 | $3.16 |
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 $23.44 Median $23.44 Typical High $23.44 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $23.44 | $23.44 | $23.44 |
Where Alabama sits
The same service costs 3.7 times more in Hawaii than in Florida. 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· 43rd of 51
$16.98
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.