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 $58.88 Median $93.33 Typical High $93.33 | Professional | None | $58.88 | $93.33 | $93.33 |
Cigna Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Facility | None | $72.44 | $72.44 | $72.44 |
Cigna Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $72.44 | Professional | None | $53.70 | $53.70 | $72.44 |
United Setting Facility Modifier None Typical Low $47.86 Median $112.20 Typical High $131.83 | Facility | None | $47.86 | $112.20 | $131.83 |
United Setting Professional Modifier None Typical Low $32.36 Median $46.77 Typical High $69.18 | Professional | None | $32.36 | $46.77 | $69.18 |
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 $30.90 Median $46.77 Typical High $46.77 | Professional | 52 · Reduced service | $30.90 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $18.62 Typical High $18.62 | Professional | 53 · Discontinued | $12.30 | $18.62 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $14.13 Typical High $14.13 | Professional | 55 · Aftercare only | $9.33 | $14.13 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $9.33 Typical High $9.33 | Professional | 56 · Pre-op care only | $6.17 | $9.33 | $9.33 |
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 $72.44 Median $72.44 Typical High $72.44 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $72.44 | $72.44 | $72.44 |
Where Alabama sits
The same service costs 3.2 times more in Hawaii than in Florida. 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· 50th of 51
$53.70
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.