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 $44.67 Median $70.79 Typical High $70.79 | Professional | None | $44.67 | $70.79 | $70.79 |
Cigna Setting Facility Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Facility | None | $41.69 | $41.69 | $41.69 |
Cigna Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $41.69 | Professional | None | $30.90 | $30.90 | $41.69 |
United Setting Facility Modifier None Typical Low $77.62 Median $91.20 Typical High $91.20 | Facility | None | $77.62 | $91.20 | $91.20 |
United Setting Professional Modifier None Typical Low $22.39 Median $34.67 Typical High $47.86 | Professional | None | $22.39 | $34.67 | $47.86 |
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 $22.39 Median $35.48 Typical High $35.48 | Professional | 52 · Reduced service | $22.39 | $35.48 | $35.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $14.13 Typical High $14.13 | Professional | 53 · Discontinued | $8.91 | $14.13 | $14.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $10.72 Typical High $10.72 | Professional | 55 · Aftercare only | $6.61 | $10.72 | $10.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $7.08 Typical High $7.08 | Professional | 56 · Pre-op care only | $4.47 | $7.08 | $7.08 |
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 $56.23 Median $56.23 Typical High $56.23 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $56.23 | $56.23 | $56.23 |
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
$38.02
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.