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 $27.54 Median $43.65 Typical High $43.65 | Professional | None | $27.54 | $43.65 | $43.65 |
Cigna Setting Facility Modifier None Typical Low $26.92 Median $26.92 Typical High $26.92 | Facility | None | $26.92 | $26.92 | $26.92 |
Cigna Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $26.92 | Professional | None | $19.95 | $19.95 | $26.92 |
United Setting Facility Modifier None Typical Low $47.86 Median $56.23 Typical High $56.23 | Facility | None | $47.86 | $56.23 | $56.23 |
United Setting Professional Modifier None Typical Low $13.80 Median $21.38 Typical High $29.51 | Professional | None | $13.80 | $21.38 | $29.51 |
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 $13.49 Median $21.88 Typical High $21.88 | Professional | 52 · Reduced service | $13.49 | $21.88 | $21.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.50 Median $8.71 Typical High $8.71 | Professional | 53 · Discontinued | $5.50 | $8.71 | $8.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.07 Median $6.46 Typical High $6.46 | Professional | 55 · Aftercare only | $4.07 | $6.46 | $6.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.75 Median $4.37 Typical High $4.37 | Professional | 56 · Pre-op care only | $2.75 | $4.37 | $4.37 |
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 $31.62 Median $31.62 Typical High $31.62 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $31.62 | $31.62 | $31.62 |
Where Alabama sits
The same service costs 2.5 times more in Montana than in Delaware. 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
$22.91
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.