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 $22.91 Median $38.90 Typical High $38.90 | Professional | None | $22.91 | $38.90 | $38.90 |
Cigna Setting Facility Modifier None Typical Low $22.91 Median $22.91 Typical High $22.91 | Facility | None | $22.91 | $22.91 | $22.91 |
Cigna Setting Professional Modifier None Typical Low $16.98 Median $16.98 Typical High $22.91 | Professional | None | $16.98 | $16.98 | $22.91 |
United Setting Facility Modifier None Typical Low $42.66 Median $50.12 Typical High $50.12 | Facility | None | $42.66 | $50.12 | $50.12 |
United Setting Professional Modifier None Typical Low $12.30 Median $19.05 Typical High $26.30 | Professional | None | $12.30 | $19.05 | $26.30 |
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 $12.30 Median $19.50 Typical High $19.50 | Professional | 52 · Reduced service | $12.30 | $19.50 | $19.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.90 Median $7.76 Typical High $7.76 | Professional | 53 · Discontinued | $4.90 | $7.76 | $7.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.72 Median $5.89 Typical High $5.89 | Professional | 55 · Aftercare only | $3.72 | $5.89 | $5.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $3.89 Typical High $3.89 | Professional | 56 · Pre-op care only | $2.45 | $3.89 | $3.89 |
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 $33.88 Median $33.88 Typical High $33.88 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $33.88 | $33.88 | $33.88 |
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· 36th of 51
$20.89
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.