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 $31.62 Median $50.12 Typical High $50.12 | Professional | None | $31.62 | $50.12 | $50.12 |
Cigna Setting Facility Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Facility | None | $38.90 | $38.90 | $38.90 |
Cigna Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $38.90 | Professional | None | $28.84 | $28.84 | $38.90 |
United Setting Facility Modifier None Typical Low $35.48 Median $61.66 Typical High $72.44 | Facility | None | $35.48 | $61.66 | $72.44 |
United Setting Professional Modifier None Typical Low $17.78 Median $25.70 Typical High $38.02 | Professional | None | $17.78 | $25.70 | $38.02 |
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 $16.98 Median $25.12 Typical High $25.12 | Professional | 52 · Reduced service | $16.98 | $25.12 | $25.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.92 Median $10.00 Typical High $10.00 | Professional | 53 · Discontinued | $6.92 | $10.00 | $10.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $7.59 Typical High $7.59 | Professional | 55 · Aftercare only | $5.13 | $7.59 | $7.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.47 Median $5.01 Typical High $5.01 | Professional | 56 · Pre-op care only | $3.47 | $5.01 | $5.01 |
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 $38.90 Median $38.90 Typical High $38.90 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $38.90 | $38.90 | $38.90 |
Where Alabama sits
The same service costs 4.7 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· 47th of 51
$28.84
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.