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 $38.90 Median $61.66 Typical High $61.66 | Professional | None | $38.90 | $61.66 | $61.66 |
Cigna Setting Facility Modifier None Typical Low $46.77 Median $46.77 Typical High $51.29 | Facility | None | $46.77 | $46.77 | $51.29 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $46.77 | Professional | None | $33.88 | $33.88 | $46.77 |
United Setting Facility Modifier None Typical Low $43.65 Median $75.86 Typical High $89.13 | Facility | None | $43.65 | $75.86 | $89.13 |
United Setting Professional Modifier None Typical Low $21.88 Median $31.62 Typical High $46.77 | Professional | None | $21.88 | $31.62 | $46.77 |
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 $22.91 Median $30.90 Typical High $30.90 | Professional | 52 · Reduced service | $22.91 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $12.30 Typical High $12.30 | Professional | 53 · Discontinued | $9.12 | $12.30 | $12.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $9.33 Typical High $9.33 | Professional | 55 · Aftercare only | $6.92 | $9.33 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $6.17 Typical High $6.17 | Professional | 56 · Pre-op care only | $4.57 | $6.17 | $6.17 |
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 $51.29 Median $51.29 Typical High $51.29 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $51.29 | $51.29 | $51.29 |
Where Alabama sits
The same service costs 3.1 times more in Hawaii than in Florida. 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· 50th of 51
$33.88
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.