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 $14.79 Median $16.98 Typical High $16.98 | Professional | None | $14.79 | $16.98 | $16.98 |
Cigna Setting Facility Modifier None Typical Low $28.18 Median $28.18 Typical High $28.18 | Facility | None | $28.18 | $28.18 | $28.18 |
Cigna Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $28.18 | Professional | None | $20.42 | $20.42 | $28.18 |
United Setting Professional Modifier None Typical Low $9.33 Median $12.59 Typical High $23.44 | Professional | None | $9.33 | $12.59 | $23.44 |
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 $7.41 Median $8.51 Typical High $8.51 | Professional | 52 · Reduced service | $7.41 | $8.51 | $8.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.02 Median $3.47 Typical High $3.47 | Professional | 53 · Discontinued | $3.02 | $3.47 | $3.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.24 Median $2.57 Typical High $2.57 | Professional | 55 · Aftercare only | $2.24 | $2.57 | $2.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.51 Median $1.74 Typical High $1.74 | Professional | 56 · Pre-op care only | $1.51 | $1.74 | $1.74 |
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 $15.14 Median $15.14 Typical High $15.14 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $15.14 | $15.14 | $15.14 |
Where Alabama sits
The same service costs 8.7 times more in Hawaii 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· 43rd of 51
$16.98
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.