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 $28.84 Median $46.77 Typical High $46.77 | Professional | None | $28.84 | $46.77 | $46.77 |
Cigna Setting Facility Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Facility | None | $33.88 | $33.88 | $33.88 |
Cigna Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $33.88 | Professional | None | $24.55 | $24.55 | $33.88 |
United Setting Facility Modifier None Typical Low $50.12 Median $60.26 Typical High $60.26 | Facility | None | $50.12 | $60.26 | $60.26 |
United Setting Professional Modifier None Typical Low $14.45 Median $22.91 Typical High $31.62 | Professional | None | $14.45 | $22.91 | $31.62 |
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 $14.45 Median $23.44 Typical High $23.44 | Professional | 52 · Reduced service | $14.45 | $23.44 | $23.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $9.33 Typical High $9.33 | Professional | 53 · Discontinued | $5.75 | $9.33 | $9.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $6.92 Typical High $6.92 | Professional | 55 · Aftercare only | $4.37 | $6.92 | $6.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.88 Median $4.68 Typical High $4.68 | Professional | 56 · Pre-op care only | $2.88 | $4.68 | $4.68 |
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 $38.02 Median $38.02 Typical High $38.02 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $38.02 | $38.02 | $38.02 |
Where Alabama sits
The same service costs 3.1 times more in Montana 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· 50th of 51
$24.55
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.