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 $123.03 Median $194.98 Typical High $194.98 | Professional | None | $123.03 | $194.98 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Facility | None | $120.23 | $120.23 | $120.23 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $120.23 | Professional | None | $87.10 | $87.10 | $120.23 |
United Setting Facility Modifier None Typical Low $72.44 Median $194.98 Typical High $229.09 | Facility | None | $72.44 | $194.98 | $229.09 |
United Setting Professional Modifier None Typical Low $56.23 Median $93.33 Typical High $120.23 | Professional | None | $56.23 | $93.33 | $120.23 |
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 $60.26 Median $97.72 Typical High $97.72 | Professional | 52 · Reduced service | $60.26 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $38.90 Typical High $38.90 | Professional | 53 · Discontinued | $24.55 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $28.84 Typical High $28.84 | Professional | 55 · Aftercare only | $18.20 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $19.50 Typical High $19.50 | Professional | 56 · Pre-op care only | $12.30 | $19.50 | $19.50 |
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 $154.88 Median $154.88 Typical High $154.88 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $154.88 | $154.88 | $154.88 |
Where Alabama sits
The same service costs 2.4 times more in Montana than in Vermont. 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· 41st of 51
$100
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.