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 $213.80 Median $295.12 Typical High $295.12 | Professional | None | $213.80 | $295.12 | $295.12 |
Ambetter Setting Professional Modifier None Typical Low $309.03 Median $416.87 Typical High $416.87 | Professional | None | $309.03 | $416.87 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Facility | None | $302.00 | $302.00 | $302.00 |
Cigna Setting Facility Modifier RR · Rental Typical Low $30.20 Median $30.20 Typical High $30.20 | Facility | RR · Rental | $30.20 | $30.20 | $30.20 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $302.00 | Professional | None | $218.78 | $218.78 | $302.00 |
Cigna Setting Professional Modifier RR · Rental Typical Low $25.70 Median $25.70 Typical High $30.20 | Professional | RR · Rental | $25.70 | $25.70 | $30.20 |
United Setting Facility Modifier None Typical Low $416.87 Median $489.78 Typical High $489.78 | Facility | None | $416.87 | $489.78 | $489.78 |
United Setting Professional Modifier None Typical Low $147.91 Median $234.42 Typical High $331.13 | Professional | None | $147.91 | $234.42 | $331.13 |
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 $114.82 Median $144.54 Typical High $144.54 | Professional | 52 · Reduced service | $114.82 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $58.88 Typical High $58.88 | Professional | 53 · Discontinued | $45.71 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $43.65 Typical High $43.65 | Professional | 55 · Aftercare only | $34.67 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $29.51 Typical High $29.51 | Professional | 56 · Pre-op care only | $22.91 | $29.51 | $29.51 |
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 $331.13 Median $331.13 Typical High $331.13 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $331.13 | $331.13 | $331.13 |
Where Alabama sits
The same service costs 2.6 times more in Hawaii than in Utah. 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· 34th of 51
$251
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.