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 $75.86 Median $120.23 Typical High $120.23 | Professional | None | $75.86 | $120.23 | $120.23 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Facility | None | $70.79 | $70.79 | $70.79 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $70.79 | Professional | None | $51.29 | $51.29 | $70.79 |
United Setting Facility Modifier None Typical Low $131.83 Median $154.88 Typical High $154.88 | Facility | None | $131.83 | $154.88 | $154.88 |
United Setting Professional Modifier None Typical Low $38.02 Median $58.88 Typical High $81.28 | Professional | None | $38.02 | $58.88 | $81.28 |
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 $38.02 Median $60.26 Typical High $60.26 | Professional | 52 · Reduced service | $38.02 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $23.99 Typical High $23.99 | Professional | 53 · Discontinued | $15.14 | $23.99 | $23.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $18.20 Typical High $18.20 | Professional | 55 · Aftercare only | $11.22 | $18.20 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $12.02 Typical High $12.02 | Professional | 56 · Pre-op care only | $7.59 | $12.02 | $12.02 |
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 $95.50 Median $95.50 Typical High $95.50 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $95.50 | $95.50 | $95.50 |
Where Alabama sits
The same service costs 2.6 times more in Hawaii 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· 42nd of 51
$63.10
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.