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 Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $100.00 Typical High $100.00 | Professional | None | $69.18 | $100.00 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Facility | None | $66.07 | $66.07 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $66.07 | Professional | None | $48.98 | $48.98 | $66.07 |
United Setting Facility Modifier None Typical Low $61.66 Median $120.23 Typical High $141.25 | Facility | None | $61.66 | $120.23 | $141.25 |
United Setting Professional Modifier None Typical Low $34.67 Median $50.12 Typical High $74.13 | Professional | None | $34.67 | $50.12 | $74.13 |
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 $36.31 Median $50.12 Typical High $50.12 | Professional | 52 · Reduced service | $36.31 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $19.95 Typical High $19.95 | Professional | 53 · Discontinued | $14.45 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $14.79 Typical High $14.79 | Professional | 55 · Aftercare only | $10.96 | $14.79 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $10.00 Typical High $10.00 | Professional | 56 · Pre-op care only | $7.24 | $10.00 | $10.00 |
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 $61.66 Median $61.66 Typical High $61.66 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $61.66 | $61.66 | $61.66 |
Where Alabama sits
The same service costs 3.5 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· 48th of 51
$52.48
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.