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 $120.23 Median $190.55 Typical High $190.55 | Professional | None | $120.23 | $190.55 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Facility | None | $123.03 | $123.03 | $123.03 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $123.03 | Professional | None | $89.13 | $89.13 | $123.03 |
United Setting Facility Modifier None Typical Low $87.10 Median $204.17 Typical High $239.88 | Facility | None | $87.10 | $204.17 | $239.88 |
United Setting Professional Modifier None Typical Low $58.88 Median $93.33 Typical High $125.89 | Professional | None | $58.88 | $93.33 | $125.89 |
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 $58.88 Median $93.33 Typical High $93.33 | Professional | 52 · Reduced service | $58.88 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $38.02 Typical High $38.02 | Professional | 53 · Discontinued | $23.99 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $28.18 Typical High $28.18 | Professional | 55 · Aftercare only | $17.78 | $28.18 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $19.05 Typical High $19.05 | Professional | 56 · Pre-op care only | $12.02 | $19.05 | $19.05 |
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 $162.18 Median $162.18 Typical High $162.18 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $162.18 | $162.18 | $162.18 |
Where Alabama sits
The same service costs 2.5 times more in Hawaii than in Arizona. 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
$100
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.