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 $35.48 Median $56.23 Typical High $56.23 | Professional | None | $35.48 | $56.23 | $56.23 |
Cigna Setting Facility Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Facility | None | $33.11 | $33.11 | $33.11 |
Cigna Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $33.11 | Professional | None | $24.55 | $24.55 | $33.11 |
United Setting Facility Modifier None Typical Low $61.66 Median $72.44 Typical High $72.44 | Facility | None | $61.66 | $72.44 | $72.44 |
United Setting Professional Modifier None Typical Low $17.78 Median $27.54 Typical High $38.02 | Professional | None | $17.78 | $27.54 | $38.02 |
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 $17.78 Median $28.18 Typical High $28.18 | Professional | 52 · Reduced service | $17.78 | $28.18 | $28.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.08 Median $11.22 Typical High $11.22 | Professional | 53 · Discontinued | $7.08 | $11.22 | $11.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $8.51 Typical High $8.51 | Professional | 55 · Aftercare only | $5.37 | $8.51 | $8.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.55 Median $5.62 Typical High $5.62 | Professional | 56 · Pre-op care only | $3.55 | $5.62 | $5.62 |
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 $48.98 Median $48.98 Typical High $48.98 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $48.98 | $48.98 | $48.98 |
Where Alabama sits
The same service costs 2.6 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· 41st of 51
$30.20
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.