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 $52.48 Median $83.18 Typical High $83.18 | Professional | None | $52.48 | $83.18 | $83.18 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Facility | None | $66.07 | $66.07 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $66.07 | Professional | None | $47.86 | $47.86 | $66.07 |
United Setting Facility Modifier None Typical Low $58.88 Median $102.33 Typical High $120.23 | Facility | None | $58.88 | $102.33 | $120.23 |
United Setting Professional Modifier None Typical Low $29.51 Median $41.69 Typical High $63.10 | Professional | None | $29.51 | $41.69 | $63.10 |
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 $28.18 Median $41.69 Typical High $41.69 | Professional | 52 · Reduced service | $28.18 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $16.60 Typical High $16.60 | Professional | 53 · Discontinued | $11.22 | $16.60 | $16.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $12.30 Typical High $12.30 | Professional | 55 · Aftercare only | $8.51 | $12.30 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $8.32 Typical High $8.32 | Professional | 56 · Pre-op care only | $5.62 | $8.32 | $8.32 |
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 $67.61 Median $67.61 Typical High $67.61 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $67.61 | $67.61 | $67.61 |
Where Alabama sits
The same service costs 3.6 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· 46th of 51
$47.86
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.