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 $30.90 Median $48.98 Typical High $48.98 | Professional | None | $30.90 | $48.98 | $48.98 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Facility | None | $34.67 | $34.67 | $34.67 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $34.67 | Professional | None | $25.70 | $25.70 | $34.67 |
United Setting Facility Modifier None Typical Low $53.70 Median $63.10 Typical High $63.10 | Facility | None | $53.70 | $63.10 | $63.10 |
United Setting Professional Modifier None Typical Low $15.49 Median $23.99 Typical High $33.11 | Professional | None | $15.49 | $23.99 | $33.11 |
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 $15.49 Median $24.55 Typical High $24.55 | Professional | 52 · Reduced service | $15.49 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.17 Median $9.77 Typical High $9.77 | Professional | 53 · Discontinued | $6.17 | $9.77 | $9.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.68 Median $7.41 Typical High $7.41 | Professional | 55 · Aftercare only | $4.68 | $7.41 | $7.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $4.90 Typical High $4.90 | Professional | 56 · Pre-op care only | $3.09 | $4.90 | $4.90 |
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 $36.31 Median $36.31 Typical High $36.31 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $36.31 | $36.31 | $36.31 |
Where Alabama sits
The same service costs 2.1 times more in Montana than in New Jersey. 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
$26.30
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.