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 $60.26 Median $89.13 Typical High $95.50 | Professional | None | $60.26 | $89.13 | $95.50 |
Ambetter Setting Professional Modifier None Typical Low $74.13 Median $102.33 Typical High $102.33 | Professional | None | $74.13 | $102.33 | $102.33 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Facility | None | $61.66 | $61.66 | $61.66 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $61.66 | Professional | None | $44.67 | $44.67 | $61.66 |
United Setting Facility Modifier None Typical Low $72.44 Median $109.65 Typical High $131.83 | Facility | None | $72.44 | $109.65 | $131.83 |
United Setting Professional Modifier None Typical Low $31.62 Median $47.86 Typical High $64.57 | Professional | None | $31.62 | $47.86 | $64.57 |
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 $31.62 Median $44.67 Typical High $44.67 | Professional | 52 · Reduced service | $31.62 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $18.20 Typical High $18.20 | Professional | 53 · Discontinued | $12.59 | $18.20 | $18.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $13.49 Typical High $13.49 | Professional | 55 · Aftercare only | $9.33 | $13.49 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $9.12 Typical High $9.12 | Professional | 56 · Pre-op care only | $6.31 | $9.12 | $9.12 |
BCBS Setting Professional Modifier 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $66.07 | $66.07 | $66.07 |
Where Alabama sits
The same service costs 2.1 times more in Wisconsin 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
$48.98
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.