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 $20.89 Median $23.99 Typical High $23.99 | Professional | None | $20.89 | $23.99 | $23.99 |
Cigna Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Facility | None | $54.95 | $54.95 | $54.95 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $54.95 | Professional | None | $39.81 | $39.81 | $54.95 |
United Setting Professional Modifier None Typical Low $12.88 Median $17.38 Typical High $32.36 | Professional | None | $12.88 | $17.38 | $32.36 |
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 $10.23 Median $12.02 Typical High $12.02 | Professional | 52 · Reduced service | $10.23 | $12.02 | $12.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.17 Median $4.79 Typical High $4.79 | Professional | 53 · Discontinued | $4.17 | $4.79 | $4.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.09 Median $3.55 Typical High $3.55 | Professional | 55 · Aftercare only | $3.09 | $3.55 | $3.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.04 Median $2.40 Typical High $2.40 | Professional | 56 · Pre-op care only | $2.04 | $2.40 | $2.40 |
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 $123.03 Median $123.03 Typical High $123.03 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $123.03 | $123.03 | $123.03 |
Where Alabama sits
The same service costs 8.9 times more in North Dakota than in Colorado. 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· 45th of 51
$23.99
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.