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 $23.99 Median $27.54 Typical High $27.54 | Professional | None | $23.99 | $27.54 | $27.54 |
Cigna Setting Facility Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Facility | None | $30.20 | $30.20 | $30.20 |
Cigna Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $30.20 | Professional | None | $21.88 | $21.88 | $30.20 |
United Setting Professional Modifier None Typical Low $15.14 Median $19.95 Typical High $37.15 | Professional | None | $15.14 | $19.95 | $37.15 |
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 $12.02 Median $13.80 Typical High $13.80 | Professional | 52 · Reduced service | $12.02 | $13.80 | $13.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.79 Median $5.50 Typical High $5.50 | Professional | 53 · Discontinued | $4.79 | $5.50 | $5.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.63 Median $4.07 Typical High $4.07 | Professional | 55 · Aftercare only | $3.63 | $4.07 | $4.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.40 Median $2.75 Typical High $2.75 | Professional | 56 · Pre-op care only | $2.40 | $2.75 | $2.75 |
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 $32.36 Median $32.36 Typical High $32.36 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $32.36 | $32.36 | $32.36 |
Where Alabama sits
The same service costs 6.5 times more in Kansas than in Hawaii. 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
$22.39
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.