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 $81.28 Median $144.54 Typical High $144.54 | Professional | None | $81.28 | $144.54 | $144.54 |
Ambetter Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | None | $117.49 | $117.49 | $117.49 |
Cigna Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Facility | None | $87.10 | $87.10 | $87.10 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $87.10 | Professional | None | $63.10 | $63.10 | $87.10 |
United Setting Facility Modifier None Typical Low $91.20 Median $154.88 Typical High $186.21 | Facility | None | $91.20 | $154.88 | $186.21 |
United Setting Professional Modifier None Typical Low $44.67 Median $70.79 Typical High $97.72 | Professional | None | $44.67 | $70.79 | $97.72 |
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 $45.71 Median $72.44 Typical High $72.44 | Professional | 52 · Reduced service | $45.71 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $28.84 Typical High $28.84 | Professional | 53 · Discontinued | $18.20 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $21.88 Typical High $21.88 | Professional | 55 · Aftercare only | $13.80 | $21.88 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $14.45 Typical High $14.45 | Professional | 56 · Pre-op care only | $9.12 | $14.45 | $14.45 |
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 $109.65 Median $109.65 Typical High $109.65 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $109.65 | $109.65 | $109.65 |
Cigna Setting Professional Modifier RR · Rental Typical Low $8.71 Median $8.71 Typical High $8.71 | Professional | RR · Rental | $8.71 | $8.71 | $8.71 |
Where Alabama sits
The same service costs 5.0 times more in Hawaii than in Delaware. 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· 42nd of 51
$77.62
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.