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 $707.95 Median $1,047.13 Typical High $1,047.13 | Professional | None | $707.95 | $1,047.13 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $616.60 Typical High $616.60 | Facility | None | $616.60 | $616.60 | $616.60 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $616.60 | Professional | None | $446.68 | $446.68 | $616.60 |
United Setting Facility Modifier None Typical Low $1,148.15 Median $1,348.96 Typical High $1,348.96 | Facility | None | $1,148.15 | $1,348.96 | $1,348.96 |
United Setting Professional Modifier None Typical Low $331.13 Median $524.81 Typical High $741.31 | Professional | None | $331.13 | $524.81 | $741.31 |
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 $331.13 Median $524.81 Typical High $524.81 | Professional | 52 · Reduced service | $331.13 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $208.93 Typical High $208.93 | Professional | 53 · Discontinued | $131.83 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $154.88 Typical High $154.88 | Professional | 55 · Aftercare only | $97.72 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $104.71 Typical High $104.71 | Professional | 56 · Pre-op care only | $66.07 | $104.71 | $104.71 |
BCBS Alabama Setting Professional Modifier 12 + 21 + 22 · Increased work + 31 + 32 · Mandated service + 41 + 52 · Reduced service + 93 · Audio-only telehealth Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | 12 + 21 + 22 · Increased work + 31 + 32 · Mandated service + 41 + 52 · Reduced service + 93 · Audio-only telehealth | $831.76 | $831.76 | $831.76 |
Where Alabama sits
The same service costs 2.6 times more in Hawaii than in Delaware. 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· 46th of 51
$550
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.