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 $64.57 Median $64.57 Typical High $64.57 | Facility | None | $64.57 | $64.57 | $64.57 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $64.57 | Professional | None | $46.77 | $46.77 | $64.57 |
United Setting Facility Modifier None Typical Low $57.54 Median $100.00 Typical High $117.49 | Facility | None | $57.54 | $100.00 | $117.49 |
United Setting Professional Modifier None Typical Low $28.84 Median $47.86 Typical High $63.10 | Professional | None | $28.84 | $47.86 | $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 $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 $9.77 Median $15.85 Typical High $15.85 | Professional | 55 · Aftercare only | $9.77 | $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 $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 3.5 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· 29th 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.