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 $478.63 Median $870.96 Typical High $870.96 | Professional | None | $478.63 | $870.96 | $870.96 |
Ambetter Setting Professional Modifier None Typical Low $851.14 Median $933.25 Typical High $933.25 | Professional | None | $851.14 | $933.25 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $549.54 | Professional | None | $398.11 | $398.11 | $549.54 |
United Setting Facility Modifier None Typical Low $331.13 Median $933.25 Typical High $1,096.48 | Facility | None | $331.13 | $933.25 | $1,096.48 |
United Setting Professional Modifier None Typical Low $269.15 Median $426.58 Typical High $575.44 | Professional | None | $269.15 | $426.58 | $575.44 |
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 $281.84 Median $436.52 Typical High $436.52 | Professional | 52 · Reduced service | $281.84 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $173.78 Typical High $173.78 | Professional | 53 · Discontinued | $112.20 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $85.11 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $87.10 Typical High $87.10 | Professional | 56 · Pre-op care only | $56.23 | $87.10 | $87.10 |
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 $630.96 Median $630.96 Typical High $630.96 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $630.96 | $630.96 | $630.96 |
Where Alabama sits
The same service costs 2.4 times more in Iowa 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
$457
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.