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 $33.11 Median $53.70 Typical High $53.70 | Professional | None | $33.11 | $53.70 | $53.70 |
Cigna Setting Facility Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Facility | None | $33.11 | $33.11 | $33.11 |
Cigna Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $33.11 | Professional | None | $23.99 | $23.99 | $33.11 |
United Setting Facility Modifier None Typical Low $58.88 Median $69.18 Typical High $69.18 | Facility | None | $58.88 | $69.18 | $69.18 |
United Setting Professional Modifier None Typical Low $16.98 Median $26.30 Typical High $36.31 | Professional | None | $16.98 | $26.30 | $36.31 |
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 $16.98 Median $26.92 Typical High $26.92 | Professional | 52 · Reduced service | $16.98 | $26.92 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.76 Median $10.72 Typical High $10.72 | Professional | 53 · Discontinued | $6.76 | $10.72 | $10.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.01 Median $7.94 Typical High $7.94 | Professional | 55 · Aftercare only | $5.01 | $7.94 | $7.94 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $5.37 Typical High $5.37 | Professional | 56 · Pre-op care only | $3.39 | $5.37 | $5.37 |
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 $30.20 Median $30.20 Typical High $30.20 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $30.20 | $30.20 | $30.20 |
Where Alabama sits
The same service costs 2.6 times more in Montana than in Kansas. 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
$28.18
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.