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 $57.54 Median $102.33 Typical High $102.33 | Professional | None | $57.54 | $102.33 | $102.33 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Facility | None | $61.66 | $61.66 | $61.66 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $61.66 | Professional | None | $44.67 | $44.67 | $61.66 |
United Setting Facility Modifier None Typical Low $41.69 Median $93.33 Typical High $109.65 | Facility | None | $41.69 | $93.33 | $109.65 |
United Setting Professional Modifier None Typical Low $26.92 Median $46.77 Typical High $61.66 | Professional | None | $26.92 | $46.77 | $61.66 |
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 $20.42 Typical High $20.42 | Professional | 53 · Discontinued | $12.88 | $20.42 | $20.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $15.14 Typical High $15.14 | Professional | 55 · Aftercare only | $9.55 | $15.14 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $10.23 Typical High $10.23 | Professional | 56 · Pre-op care only | $6.46 | $10.23 | $10.23 |
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 $70.79 Median $70.79 Typical High $70.79 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $70.79 | $70.79 | $70.79 |
Where Alabama sits
The same service costs 2.5 times more in Hawaii than in Arizona. 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
$52.48
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.