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 $112.20 Median $190.55 Typical High $190.55 | Professional | None | $112.20 | $190.55 | $190.55 |
Ambetter Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | None | $154.88 | $154.88 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
Cigna Setting Facility Modifier RR · Rental Typical Low $12.59 Median $12.59 Typical High $12.59 | Facility | RR · Rental | $12.59 | $12.59 | $12.59 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $125.89 | Professional | None | $93.33 | $93.33 | $125.89 |
Cigna Setting Professional Modifier RR · Rental Typical Low $10.72 Median $10.72 Typical High $12.59 | Professional | RR · Rental | $10.72 | $10.72 | $12.59 |
United Setting Facility Modifier None Typical Low $208.93 Median $245.47 Typical High $245.47 | Facility | None | $208.93 | $245.47 | $245.47 |
United Setting Professional Modifier None Typical Low $60.26 Median $95.50 Typical High $134.90 | Professional | None | $60.26 | $95.50 | $134.90 |
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 $60.26 Median $95.50 Typical High $95.50 | Professional | 52 · Reduced service | $60.26 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $38.02 Typical High $38.02 | Professional | 53 · Discontinued | $23.99 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $28.84 Typical High $28.84 | Professional | 55 · Aftercare only | $18.20 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $19.05 Typical High $19.05 | Professional | 56 · Pre-op care only | $12.02 | $19.05 | $19.05 |
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 $154.88 Median $154.88 Typical High $154.88 | Professional | 12 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 93 · Audio-only telehealth | $154.88 | $154.88 | $154.88 |
Where Alabama sits
The same service costs 2.1 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· 48th of 51
$102
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.