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 $57.54 Typical High $57.54 | Professional | None | $33.11 | $57.54 | $57.54 |
Cigna Setting Facility Modifier None Typical Low $33.88 Median $33.88 Typical High $36.31 | Facility | None | $33.88 | $33.88 | $36.31 |
Cigna Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $33.88 | Professional | None | $25.12 | $25.12 | $33.88 |
United Setting Facility Modifier None Typical Low $63.10 Median $74.13 Typical High $74.13 | Facility | None | $63.10 | $74.13 | $74.13 |
United Setting Professional Modifier None Typical Low $18.20 Median $28.18 Typical High $38.90 | Professional | None | $18.20 | $28.18 | $38.90 |
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 $18.20 Median $28.84 Typical High $28.84 | Professional | 52 · Reduced service | $18.20 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.24 Median $11.48 Typical High $11.48 | Professional | 53 · Discontinued | $7.24 | $11.48 | $11.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $8.71 Typical High $8.71 | Professional | 55 · Aftercare only | $5.50 | $8.71 | $8.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $5.75 Typical High $5.75 | Professional | 56 · Pre-op care only | $3.63 | $5.75 | $5.75 |
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 $40.74 Median $40.74 Typical High $40.74 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $40.74 | $40.74 | $40.74 |
Where Alabama sits
The same service costs 2.8 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· 44th of 51
$30.90
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.