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 $93.33 Typical High $93.33 | Professional | None | $57.54 | $93.33 | $93.33 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Facility | None | $70.79 | $70.79 | $70.79 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $70.79 | Professional | None | $51.29 | $51.29 | $70.79 |
United Setting Facility Modifier None Typical Low $102.33 Median $120.23 Typical High $120.23 | Facility | None | $102.33 | $120.23 | $120.23 |
United Setting Professional Modifier None Typical Low $28.84 Median $45.71 Typical High $63.10 | Professional | None | $28.84 | $45.71 | $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 $28.84 Median $46.77 Typical High $46.77 | Professional | 52 · Reduced service | $28.84 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $18.62 Typical High $18.62 | Professional | 53 · Discontinued | $11.75 | $18.62 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $13.80 Typical High $13.80 | Professional | 55 · Aftercare only | $8.71 | $13.80 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $9.33 Typical High $9.33 | Professional | 56 · Pre-op care only | $5.75 | $9.33 | $9.33 |
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 $70.79 Median $70.79 Typical High $70.79 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $70.79 | $70.79 | $70.79 |
Where Alabama sits
The same service costs 2.0 times more in Hawaii than in West Virginia. 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
$51.29
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.