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 $58.88 Median $93.33 Typical High $93.33 | Professional | None | $58.88 | $93.33 | $93.33 |
Ambetter Setting Professional Modifier None Typical Low $91.20 Median $102.33 Typical High $102.33 | Professional | None | $91.20 | $102.33 | $102.33 |
Cigna Setting Facility Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Facility | None | $63.10 | $63.10 | $63.10 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $63.10 | Professional | None | $45.71 | $45.71 | $63.10 |
United Setting Facility Modifier None Typical Low $61.66 Median $107.15 Typical High $125.89 | Facility | None | $61.66 | $107.15 | $125.89 |
United Setting Professional Modifier None Typical Low $30.90 Median $45.71 Typical High $66.07 | Professional | None | $30.90 | $45.71 | $66.07 |
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 $30.20 Median $46.77 Typical High $46.77 | Professional | 52 · Reduced service | $30.20 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $18.62 Typical High $18.62 | Professional | 53 · Discontinued | $12.02 | $18.62 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $14.13 Typical High $14.13 | Professional | 55 · Aftercare only | $9.12 | $14.13 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $9.33 Typical High $9.33 | Professional | 56 · Pre-op care only | $6.03 | $9.33 | $9.33 |
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 $79.43 Median $79.43 Typical High $79.43 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $79.43 | $79.43 | $79.43 |
Where Alabama sits
The same service costs 4.3 times more in Hawaii 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· 44th of 51
$50.12
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.