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 $83.18 Median $131.83 Typical High $131.83 | Professional | None | $83.18 | $131.83 | $131.83 |
Ambetter Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
Cigna Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $85.11 | Facility | None | $77.62 | $77.62 | $85.11 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $77.62 | Professional | None | $56.23 | $56.23 | $77.62 |
United Setting Facility Modifier None Typical Low $60.26 Median $141.25 Typical High $165.96 | Facility | None | $60.26 | $141.25 | $165.96 |
United Setting Professional Modifier None Typical Low $40.74 Median $64.57 Typical High $87.10 | Professional | None | $40.74 | $64.57 | $87.10 |
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 $45.71 Median $66.07 Typical High $66.07 | Professional | 52 · Reduced service | $45.71 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $26.30 Typical High $26.30 | Professional | 53 · Discontinued | $18.20 | $26.30 | $26.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $19.95 Typical High $19.95 | Professional | 55 · Aftercare only | $13.49 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $13.18 Typical High $13.18 | Professional | 56 · Pre-op care only | $9.12 | $13.18 | $13.18 |
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 $97.72 Median $97.72 Typical High $97.72 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $97.72 | $97.72 | $97.72 |
Where Alabama sits
The same service costs 3.1 times more in Hawaii 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· 41st of 51
$70.79
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.