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 $56.23 Median $64.57 Typical High $64.57 | Professional | None | $56.23 | $64.57 | $64.57 |
Cigna Setting Facility Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Facility | None | $38.02 | $38.02 | $38.02 |
Cigna Setting Professional Modifier None Typical Low $27.54 Median $27.54 Typical High $38.02 | Professional | None | $27.54 | $27.54 | $38.02 |
United Setting Professional Modifier None Typical Low $35.48 Median $46.77 Typical High $93.33 | Professional | None | $35.48 | $46.77 | $93.33 |
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 $28.18 Median $32.36 Typical High $32.36 | Professional | 52 · Reduced service | $28.18 | $32.36 | $32.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $12.88 Typical High $12.88 | Professional | 53 · Discontinued | $11.22 | $12.88 | $12.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $9.77 Typical High $9.77 | Professional | 55 · Aftercare only | $8.51 | $9.77 | $9.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $6.46 Typical High $6.46 | Professional | 56 · Pre-op care only | $5.62 | $6.46 | $6.46 |
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 $100.00 Median $100.00 Typical High $100.00 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $100.00 | $100.00 | $100.00 |
Where Alabama sits
The same service costs 49.0 times more in North Dakota 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· 38th of 51
$46.77
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.