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 $30.20 Median $47.86 Typical High $47.86 | Professional | None | $30.20 | $47.86 | $47.86 |
Cigna Setting Facility Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Facility | None | $33.88 | $33.88 | $33.88 |
Cigna Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $33.88 | Professional | None | $24.55 | $24.55 | $33.88 |
United Setting Facility Modifier None Typical Low $52.48 Median $61.66 Typical High $61.66 | Facility | None | $52.48 | $61.66 | $61.66 |
United Setting Professional Modifier None Typical Low $15.14 Median $23.44 Typical High $32.36 | Professional | None | $15.14 | $23.44 | $32.36 |
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 $15.14 Median $23.99 Typical High $23.99 | Professional | 52 · Reduced service | $15.14 | $23.99 | $23.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.03 Median $9.55 Typical High $9.55 | Professional | 53 · Discontinued | $6.03 | $9.55 | $9.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.47 Median $7.24 Typical High $7.24 | Professional | 55 · Aftercare only | $4.47 | $7.24 | $7.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.02 Median $4.79 Typical High $4.79 | Professional | 56 · Pre-op care only | $3.02 | $4.79 | $4.79 |
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 $38.02 Median $38.02 Typical High $38.02 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $38.02 | $38.02 | $38.02 |
Where Alabama sits
The same service costs 2.2 times more in Montana than in Arizona. 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
$25.12
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.