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 $154.88 Median $251.19 Typical High $251.19 | Professional | None | $154.88 | $251.19 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Facility | None | $134.90 | $134.90 | $134.90 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $134.90 | Professional | None | $100.00 | $100.00 | $134.90 |
United Setting Facility Modifier None Typical Low $63.10 Median $234.42 Typical High $275.42 | Facility | None | $63.10 | $234.42 | $275.42 |
United Setting Professional Modifier None Typical Low $67.61 Median $117.49 Typical High $151.36 | Professional | None | $67.61 | $117.49 | $151.36 |
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 $77.62 Median $125.89 Typical High $125.89 | Professional | 52 · Reduced service | $77.62 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $50.12 Typical High $50.12 | Professional | 53 · Discontinued | $30.90 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $38.02 Typical High $38.02 | Professional | 55 · Aftercare only | $22.91 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $25.12 Typical High $25.12 | Professional | 56 · Pre-op care only | $15.49 | $25.12 | $25.12 |
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 $199.53 Median $199.53 Typical High $199.53 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $199.53 | $199.53 | $199.53 |
Where Alabama sits
The same service costs 3.9 times more in Kansas than in New Jersey. 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· 28th of 51
$132
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.