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 $57.54 Median $91.20 Typical High $91.20 | Professional | None | $57.54 | $91.20 | $91.20 |
Ambetter Setting Professional Modifier None Typical Low $79.43 Median $89.13 Typical High $89.13 | Professional | None | $79.43 | $89.13 | $89.13 |
Cigna Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Facility | None | $72.44 | $72.44 | $72.44 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $72.44 | Professional | None | $52.48 | $52.48 | $72.44 |
United Setting Facility Modifier None Typical Low $64.57 Median $112.20 Typical High $131.83 | Facility | None | $64.57 | $112.20 | $131.83 |
United Setting Professional Modifier None Typical Low $32.36 Median $46.77 Typical High $70.79 | Professional | None | $32.36 | $46.77 | $70.79 |
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 $33.11 Median $45.71 Typical High $45.71 | Professional | 52 · Reduced service | $33.11 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $18.20 Typical High $18.20 | Professional | 53 · Discontinued | $13.18 | $18.20 | $18.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $13.80 Typical High $13.80 | Professional | 55 · Aftercare only | $10.00 | $13.80 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $9.12 Typical High $9.12 | Professional | 56 · Pre-op care only | $6.61 | $9.12 | $9.12 |
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 5.0 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· 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.