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 $67.61 Median $107.15 Typical High $107.15 | Professional | None | $67.61 | $107.15 | $107.15 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Facility | None | $66.07 | $66.07 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $66.07 | Professional | None | $48.98 | $48.98 | $66.07 |
United Setting Facility Modifier None Typical Low $47.86 Median $102.33 Typical High $120.23 | Facility | None | $47.86 | $102.33 | $120.23 |
United Setting Professional Modifier None Typical Low $29.51 Median $50.12 Typical High $66.07 | Professional | None | $29.51 | $50.12 | $66.07 |
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 $33.88 Median $53.70 Typical High $53.70 | Professional | 52 · Reduced service | $33.88 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $21.38 Typical High $21.38 | Professional | 53 · Discontinued | $13.49 | $21.38 | $21.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $16.22 Typical High $16.22 | Professional | 55 · Aftercare only | $10.23 | $16.22 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $10.72 Typical High $10.72 | Professional | 56 · Pre-op care only | $6.76 | $10.72 | $10.72 |
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 $91.20 Median $91.20 Typical High $91.20 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $91.20 | $91.20 | $91.20 |
Where Alabama sits
The same service costs 3.4 times more in Hawaii than in Vermont. 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· 30th of 51
$56.23
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.