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 Facility Modifier None Typical Low $9.77 Median $9.77 Typical High $9.77 | Facility | None | $9.77 | $9.77 | $9.77 |
Aetna Setting Professional Modifier None Typical Low $7.41 Median $9.77 Typical High $11.22 | Professional | None | $7.41 | $9.77 | $11.22 |
Ambetter Setting Professional Modifier None Typical Low $7.94 Median $8.13 Typical High $9.55 | Professional | None | $7.94 | $8.13 | $9.55 |
Cigna Setting Facility Modifier None Typical Low $20.89 Median $20.89 Typical High $21.38 | Facility | None | $20.89 | $20.89 | $21.38 |
Cigna Setting Professional Modifier None Typical Low $15.49 Median $15.49 Typical High $20.89 | Professional | None | $15.49 | $15.49 | $20.89 |
United Setting Professional Modifier None Typical Low $5.37 Median $7.08 Typical High $13.18 | Professional | None | $5.37 | $7.08 | $13.18 |
6 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 $4.27 Median $4.90 Typical High $4.90 | Professional | 52 · Reduced service | $4.27 | $4.90 | $4.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.70 Median $1.95 Typical High $1.95 | Professional | 53 · Discontinued | $1.70 | $1.95 | $1.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.29 Median $1.48 Typical High $1.48 | Professional | 55 · Aftercare only | $1.29 | $1.48 | $1.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.85 Median $0.98 Typical High $0.98 | Professional | 56 · Pre-op care only | $0.85 | $0.98 | $0.98 |
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 $15.85 Median $15.85 Typical High $15.85 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $15.85 | $15.85 | $15.85 |
Cigna Setting Professional Modifier RR · Rental Typical Low $2.09 Median $2.09 Typical High $2.09 | Professional | RR · Rental | $2.09 | $2.09 | $2.09 |
Where Alabama sits
The same service costs 6.2 times more in Wyoming than in North Carolina. 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
$9.77
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.