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 $20.89 Median $33.11 Typical High $33.11 | Professional | None | $20.89 | $33.11 | $33.11 |
Cigna Setting Facility Modifier None Typical Low $24.55 Median $24.55 Typical High $24.55 | Facility | None | $24.55 | $24.55 | $24.55 |
Cigna Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $24.55 | Professional | None | $17.78 | $17.78 | $24.55 |
United Setting Facility Modifier None Typical Low $36.31 Median $42.66 Typical High $42.66 | Facility | None | $36.31 | $42.66 | $42.66 |
United Setting Professional Modifier None Typical Low $10.47 Median $16.22 Typical High $22.39 | Professional | None | $10.47 | $16.22 | $22.39 |
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 $10.47 Median $16.60 Typical High $16.60 | Professional | 52 · Reduced service | $10.47 | $16.60 | $16.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.17 Median $6.61 Typical High $6.61 | Professional | 53 · Discontinued | $4.17 | $6.61 | $6.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.16 Median $5.01 Typical High $5.01 | Professional | 55 · Aftercare only | $3.16 | $5.01 | $5.01 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.09 Median $3.31 Typical High $3.31 | Professional | 56 · Pre-op care only | $2.09 | $3.31 | $3.31 |
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 $28.84 Median $28.84 Typical High $28.84 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $28.84 | $28.84 | $28.84 |
Where Alabama sits
The same service costs 2.1 times more in Montana than in West Virginia. 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· 46th of 51
$17.78
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.