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 $114.82 Median $181.97 Typical High $181.97 | Professional | None | $114.82 | $181.97 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Facility | None | $107.15 | $107.15 | $107.15 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $107.15 | Professional | None | $79.43 | $79.43 | $107.15 |
United Setting Facility Modifier None Typical Low $199.53 Median $234.42 Typical High $234.42 | Facility | None | $199.53 | $234.42 | $234.42 |
United Setting Professional Modifier None Typical Low $57.54 Median $89.13 Typical High $123.03 | Professional | None | $57.54 | $89.13 | $123.03 |
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 $57.54 Median $91.20 Typical High $91.20 | Professional | 52 · Reduced service | $57.54 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $36.31 Typical High $36.31 | Professional | 53 · Discontinued | $22.91 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $27.54 Typical High $27.54 | Professional | 55 · Aftercare only | $17.38 | $27.54 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $18.20 Typical High $18.20 | Professional | 56 · Pre-op care only | $11.48 | $18.20 | $18.20 |
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 $131.83 Median $131.83 Typical High $131.83 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $131.83 | $131.83 | $131.83 |
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· 43rd of 51
$97.72
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.