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 $91.20 Median $151.36 Typical High $151.36 | Professional | None | $91.20 | $151.36 | $151.36 |
Cigna Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $125.89 | Facility | None | $117.49 | $117.49 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $117.49 | Professional | None | $85.11 | $85.11 | $117.49 |
United Setting Facility Modifier None Typical Low $93.33 Median $173.78 Typical High $204.17 | Facility | None | $93.33 | $173.78 | $204.17 |
United Setting Professional Modifier None Typical Low $50.12 Median $75.86 Typical High $107.15 | Professional | None | $50.12 | $75.86 | $107.15 |
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 $50.12 Median $75.86 Typical High $75.86 | Professional | 52 · Reduced service | $50.12 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $30.90 Typical High $30.90 | Professional | 53 · Discontinued | $19.95 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $22.91 Typical High $22.91 | Professional | 55 · Aftercare only | $14.79 | $22.91 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $15.14 Typical High $15.14 | Professional | 56 · Pre-op care only | $10.00 | $15.14 | $15.14 |
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 $128.82 Median $128.82 Typical High $128.82 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $128.82 | $128.82 | $128.82 |
Where Alabama sits
The same service costs 2.4 times more in Hawaii than in Colorado. 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· 49th of 51
$85.11
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.