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 $87.10 Median $123.03 Typical High $123.03 | Professional | None | $87.10 | $123.03 | $123.03 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Facility | None | $102.33 | $102.33 | $102.33 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $102.33 | Professional | None | $75.86 | $75.86 | $102.33 |
United Setting Facility Modifier None Typical Low $75.86 Median $151.36 Typical High $177.83 | Facility | None | $75.86 | $151.36 | $177.83 |
United Setting Professional Modifier None Typical Low $43.65 Median $63.10 Typical High $95.50 | Professional | None | $43.65 | $63.10 | $95.50 |
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 $43.65 Median $61.66 Typical High $61.66 | Professional | 52 · Reduced service | $43.65 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $24.55 Typical High $24.55 | Professional | 53 · Discontinued | $17.38 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $18.62 Typical High $18.62 | Professional | 55 · Aftercare only | $13.18 | $18.62 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $12.30 Typical High $12.30 | Professional | 56 · Pre-op care only | $8.71 | $12.30 | $12.30 |
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 $107.15 Median $107.15 Typical High $107.15 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $107.15 | $107.15 | $107.15 |
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· 44th of 51
$75.86
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.