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 $85.11 Median $128.82 Typical High $128.82 | Professional | None | $85.11 | $128.82 | $128.82 |
Cigna Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $89.13 | Professional | None | $66.07 | $66.07 | $89.13 |
United Setting Facility Modifier None Typical Low $93.33 Median $158.49 Typical High $190.55 | Facility | None | $93.33 | $158.49 | $190.55 |
United Setting Professional Modifier None Typical Low $45.71 Median $66.07 Typical High $100.00 | Professional | None | $45.71 | $66.07 | $100.00 |
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 $41.69 Median $64.57 Typical High $64.57 | Professional | 52 · Reduced service | $41.69 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $26.30 Typical High $26.30 | Professional | 53 · Discontinued | $16.98 | $26.30 | $26.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $19.50 Typical High $19.50 | Professional | 55 · Aftercare only | $12.59 | $19.50 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $12.88 Typical High $12.88 | Professional | 56 · Pre-op care only | $8.51 | $12.88 | $12.88 |
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 $112.20 Median $112.20 Typical High $112.20 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $112.20 | $112.20 | $112.20 |
Where Alabama sits
The same service costs 5.1 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· 46th of 51
$69.18
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.