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 $46.77 Median $74.13 Typical High $74.13 | Professional | None | $46.77 | $74.13 | $74.13 |
Cigna Setting Facility Modifier None Typical Low $40.74 Median $40.74 Typical High $40.74 | Facility | None | $40.74 | $40.74 | $40.74 |
Cigna Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $40.74 | Professional | None | $29.51 | $29.51 | $40.74 |
United Setting Facility Modifier None Typical Low $36.31 Median $72.44 Typical High $85.11 | Facility | None | $36.31 | $72.44 | $85.11 |
United Setting Professional Modifier None Typical Low $20.89 Median $34.67 Typical High $45.71 | Professional | None | $20.89 | $34.67 | $45.71 |
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 $23.44 Median $37.15 Typical High $37.15 | Professional | 52 · Reduced service | $23.44 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $14.79 Typical High $14.79 | Professional | 53 · Discontinued | $9.33 | $14.79 | $14.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $11.22 Typical High $11.22 | Professional | 55 · Aftercare only | $7.08 | $11.22 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $7.41 Typical High $7.41 | Professional | 56 · Pre-op care only | $4.68 | $7.41 | $7.41 |
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 $58.88 Median $58.88 Typical High $58.88 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $58.88 | $58.88 | $58.88 |
Where Alabama sits
The same service costs 2.7 times more in Montana 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· 31st of 51
$38.90
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.