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 $16.98 Median $26.92 Typical High $26.92 | Professional | None | $16.98 | $26.92 | $26.92 |
Cigna Setting Facility Modifier None Typical Low $15.85 Median $15.85 Typical High $15.85 | Facility | None | $15.85 | $15.85 | $15.85 |
Cigna Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $15.85 | Professional | None | $11.48 | $11.48 | $15.85 |
United Setting Facility Modifier None Typical Low $13.49 Median $29.51 Typical High $34.67 | Facility | None | $13.49 | $29.51 | $34.67 |
United Setting Professional Modifier None Typical Low $8.32 Median $13.18 Typical High $18.20 | Professional | None | $8.32 | $13.18 | $18.20 |
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 $8.51 Median $13.49 Typical High $13.49 | Professional | 52 · Reduced service | $8.51 | $13.49 | $13.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.39 Median $5.37 Typical High $5.37 | Professional | 53 · Discontinued | $3.39 | $5.37 | $5.37 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.51 Median $3.98 Typical High $3.98 | Professional | 55 · Aftercare only | $2.51 | $3.98 | $3.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.70 Median $2.69 Typical High $2.69 | Professional | 56 · Pre-op care only | $1.70 | $2.69 | $2.69 |
BCBS Alabama Setting Professional Modifier 12 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 93 · Audio-only telehealth Typical Low $19.05 Median $19.05 Typical High $19.05 | Professional | 12 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 93 · Audio-only telehealth | $19.05 | $19.05 | $19.05 |
Where Alabama sits
The same service costs 5.5 times more in Kansas 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
$14.13
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.