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 $102.33 Median $173.78 Typical High $173.78 | Professional | None | $102.33 | $173.78 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Facility | None | $91.20 | $91.20 | $91.20 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $91.20 | Professional | None | $66.07 | $66.07 | $91.20 |
United Setting Facility Modifier None Typical Low $39.81 Median $162.18 Typical High $190.55 | Facility | None | $39.81 | $162.18 | $190.55 |
United Setting Professional Modifier None Typical Low $46.77 Median $81.28 Typical High $104.71 | Professional | None | $46.77 | $81.28 | $104.71 |
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 $51.29 Median $87.10 Typical High $87.10 | Professional | 52 · Reduced service | $51.29 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $34.67 Typical High $34.67 | Professional | 53 · Discontinued | $20.42 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $26.30 Typical High $26.30 | Professional | 55 · Aftercare only | $15.14 | $26.30 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $17.38 Typical High $17.38 | Professional | 56 · Pre-op care only | $10.23 | $17.38 | $17.38 |
BCBS Setting Professional Modifier 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $138.04 | $138.04 | $138.04 |
Where Alabama sits
The same service costs 2.5 times more in Montana 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· 23rd of 51
$91.20
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.