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 $66.07 Median $104.71 Typical High $104.71 | Professional | None | $66.07 | $104.71 | $104.71 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Facility | None | $75.86 | $75.86 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $75.86 | Professional | None | $54.95 | $54.95 | $75.86 |
United Setting Facility Modifier None Typical Low $69.18 Median $125.89 Typical High $147.91 | Facility | None | $69.18 | $125.89 | $147.91 |
United Setting Professional Modifier None Typical Low $35.48 Median $53.70 Typical High $77.62 | Professional | None | $35.48 | $53.70 | $77.62 |
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 $33.11 Median $52.48 Typical High $52.48 | Professional | 52 · Reduced service | $33.11 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $20.89 Typical High $20.89 | Professional | 53 · Discontinued | $13.18 | $20.89 | $20.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $15.85 Typical High $15.85 | Professional | 55 · Aftercare only | $10.00 | $15.85 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $10.47 Typical High $10.47 | Professional | 56 · Pre-op care only | $6.61 | $10.47 | $10.47 |
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 $74.13 Median $74.13 Typical High $74.13 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $74.13 | $74.13 | $74.13 |
Where Alabama sits
The same service costs 3.1 times more in Hawaii 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· 48th 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.