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 $61.66 Median $100.00 Typical High $100.00 | Professional | None | $61.66 | $100.00 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Facility | None | $67.61 | $67.61 | $67.61 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $67.61 | Professional | None | $50.12 | $50.12 | $67.61 |
United Setting Facility Modifier None Typical Low $32.36 Median $109.65 Typical High $128.82 | Facility | None | $32.36 | $109.65 | $128.82 |
United Setting Professional Modifier None Typical Low $30.90 Median $48.98 Typical High $67.61 | Professional | None | $30.90 | $48.98 | $67.61 |
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 $30.90 Median $50.12 Typical High $50.12 | Professional | 52 · Reduced service | $30.90 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $19.95 Typical High $19.95 | Professional | 53 · Discontinued | $12.59 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $14.79 Typical High $14.79 | Professional | 55 · Aftercare only | $9.33 | $14.79 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $10.00 Typical High $10.00 | Professional | 56 · Pre-op care only | $6.17 | $10.00 | $10.00 |
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 $87.10 Median $87.10 Typical High $87.10 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $87.10 | $87.10 | $87.10 |
Where Alabama sits
The same service costs 2.1 times more in Montana 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· 44th of 51
$52.48
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.