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 $43.65 Median $64.57 Typical High $64.57 | Professional | None | $43.65 | $64.57 | $64.57 |
Cigna Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Facility | None | $36.31 | $36.31 | $36.31 |
Cigna Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $36.31 | Professional | None | $26.92 | $26.92 | $36.31 |
United Setting Facility Modifier None Typical Low $38.90 Median $77.62 Typical High $91.20 | Facility | None | $38.90 | $77.62 | $91.20 |
United Setting Professional Modifier None Typical Low $22.39 Median $32.36 Typical High $47.86 | Professional | None | $22.39 | $32.36 | $47.86 |
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 $21.88 Median $32.36 Typical High $32.36 | Professional | 52 · Reduced service | $21.88 | $32.36 | $32.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $12.88 Typical High $12.88 | Professional | 53 · Discontinued | $8.91 | $12.88 | $12.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $9.55 Typical High $9.55 | Professional | 55 · Aftercare only | $6.61 | $9.55 | $9.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $6.46 Typical High $6.46 | Professional | 56 · Pre-op care only | $4.37 | $6.46 | $6.46 |
BCBS Alabama Setting Professional Modifier 12 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 55 · Aftercare only + 99 · Multiple modifiers Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | 12 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 55 · Aftercare only + 99 · Multiple modifiers | $50.12 | $50.12 | $50.12 |
Where Alabama sits
The same service costs 2.9 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· 49th of 51
$33.88
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.