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 $79.43 Median $79.43 Typical High $151.36 | Facility | None | $79.43 | $79.43 | $151.36 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $79.43 Typical High $79.43 | Professional | None | $52.48 | $79.43 | $79.43 |
Cigna Setting Facility Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Facility | None | $46.77 | $46.77 | $46.77 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $46.77 | Professional | None | $33.88 | $33.88 | $46.77 |
United Setting Facility Modifier None Typical Low $19.05 Median $83.18 Typical High $97.72 | Facility | None | $19.05 | $83.18 | $97.72 |
United Setting Professional Modifier None Typical Low $23.99 Median $38.90 Typical High $51.29 | Professional | None | $23.99 | $38.90 | $51.29 |
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 $26.92 Median $39.81 Typical High $39.81 | Professional | 52 · Reduced service | $26.92 | $39.81 | $39.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $15.85 Typical High $15.85 | Professional | 53 · Discontinued | $10.72 | $15.85 | $15.85 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $12.02 Typical High $12.02 | Professional | 55 · Aftercare only | $8.13 | $12.02 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $7.94 Typical High $7.94 | Professional | 56 · Pre-op care only | $5.37 | $7.94 | $7.94 |
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 $69.18 Median $69.18 Typical High $69.18 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $69.18 | $69.18 | $69.18 |
Where Alabama sits
The same service costs 2.9 times more in Kansas than in Delaware. 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· 42nd of 51
$42.66
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.