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 $102.33 Median $162.18 Typical High $162.18 | Professional | None | $102.33 | $162.18 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Facility | None | $117.49 | $117.49 | $117.49 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $117.49 | Professional | None | $85.11 | $85.11 | $117.49 |
United Setting Facility Modifier None Typical Low $57.54 Median $177.83 Typical High $208.93 | Facility | None | $57.54 | $177.83 | $208.93 |
United Setting Professional Modifier None Typical Low $51.29 Median $79.43 Typical High $109.65 | Professional | None | $51.29 | $79.43 | $109.65 |
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 $51.29 Median $81.28 Typical High $81.28 | Professional | 52 · Reduced service | $51.29 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $32.36 Typical High $32.36 | Professional | 53 · Discontinued | $20.42 | $32.36 | $32.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $24.55 Typical High $24.55 | Professional | 55 · Aftercare only | $15.49 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $16.22 Typical High $16.22 | Professional | 56 · Pre-op care only | $10.23 | $16.22 | $16.22 |
BCBS Alabama Setting Professional Modifier 12 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 93 · Audio-only telehealth Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | 12 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 93 · Audio-only telehealth | $141.25 | $141.25 | $141.25 |
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· 43rd of 51
$87.10
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.