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 $67.61 Median $138.04 Typical High $138.04 | Professional | None | $67.61 | $138.04 | $138.04 |
Ambetter Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | None | $112.20 | $112.20 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $89.13 | Professional | None | $64.57 | $64.57 | $89.13 |
United Setting Facility Modifier None Typical Low $72.44 Median $128.82 Typical High $151.36 | Facility | None | $72.44 | $128.82 | $151.36 |
United Setting Professional Modifier None Typical Low $37.15 Median $63.10 Typical High $83.18 | Professional | None | $37.15 | $63.10 | $83.18 |
6 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 $43.65 Median $69.18 Typical High $69.18 | Professional | 52 · Reduced service | $43.65 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $27.54 Typical High $27.54 | Professional | 53 · Discontinued | $17.38 | $27.54 | $27.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $20.89 Typical High $20.89 | Professional | 55 · Aftercare only | $12.88 | $20.89 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $13.80 Typical High $13.80 | Professional | 56 · Pre-op care only | $8.71 | $13.80 | $13.80 |
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 $95.50 Median $95.50 Typical High $95.50 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $95.50 | $95.50 | $95.50 |
Cigna Setting Professional Modifier RR · Rental Typical Low $8.91 Median $8.91 Typical High $8.91 | Professional | RR · Rental | $8.91 | $8.91 | $8.91 |
Where Alabama sits
The same service costs 2.8 times more in Hawaii than in Washington, DC. 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· 28th of 51
$72.44
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.