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 $36.31 Typical High $36.31 | Professional | None | $22.91 | $36.31 | $36.31 |
Cigna Setting Facility Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Facility | None | $25.70 | $25.70 | $25.70 |
Cigna Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $25.70 | Professional | None | $18.62 | $18.62 | $25.70 |
United Setting Facility Modifier None Typical Low $39.81 Median $46.77 Typical High $46.77 | Facility | None | $39.81 | $46.77 | $46.77 |
United Setting Professional Modifier None Typical Low $11.48 Median $17.78 Typical High $24.55 | Professional | None | $11.48 | $17.78 | $24.55 |
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 $11.48 Median $18.20 Typical High $18.20 | Professional | 52 · Reduced service | $11.48 | $18.20 | $18.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.57 Median $7.24 Typical High $7.24 | Professional | 53 · Discontinued | $4.57 | $7.24 | $7.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.39 Median $5.37 Typical High $5.37 | Professional | 55 · Aftercare only | $3.39 | $5.37 | $5.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.29 Median $3.63 Typical High $3.63 | Professional | 56 · Pre-op care only | $2.29 | $3.63 | $3.63 |
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 2.2 times more in Montana than in New Jersey. 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
$19.05
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.