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 $63.10 Median $104.71 Typical High $104.71 | Professional | None | $63.10 | $104.71 | $104.71 |
Cigna Setting Facility Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Facility | None | $63.10 | $63.10 | $63.10 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $63.10 | Professional | None | $45.71 | $45.71 | $63.10 |
United Setting Facility Modifier None Typical Low $56.23 Median $100.00 Typical High $120.23 | Facility | None | $56.23 | $100.00 | $120.23 |
United Setting Professional Modifier None Typical Low $28.84 Median $48.98 Typical High $63.10 | Professional | None | $28.84 | $48.98 | $63.10 |
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 $32.36 Median $51.29 Typical High $51.29 | Professional | 52 · Reduced service | $32.36 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $20.89 Typical High $20.89 | Professional | 53 · Discontinued | $12.88 | $20.89 | $20.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $15.49 Typical High $15.49 | Professional | 55 · Aftercare only | $9.77 | $15.49 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $10.47 Typical High $10.47 | Professional | 56 · Pre-op care only | $6.46 | $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 $69.18 Median $69.18 Typical High $69.18 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $69.18 | $69.18 | $69.18 |
Where Alabama sits
The same service costs 3.2 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· 31st of 51
$54.95
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.