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 $51.29 Median $87.10 Typical High $87.10 | Professional | None | $51.29 | $87.10 | $87.10 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $63.10 | Facility | None | $56.23 | $56.23 | $63.10 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $56.23 | Professional | None | $41.69 | $41.69 | $56.23 |
United Setting Facility Modifier None Typical Low $44.67 Median $95.50 Typical High $112.20 | Facility | None | $44.67 | $95.50 | $112.20 |
United Setting Professional Modifier None Typical Low $27.54 Median $43.65 Typical High $58.88 | Professional | None | $27.54 | $43.65 | $58.88 |
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 $27.54 Median $43.65 Typical High $43.65 | Professional | 52 · Reduced service | $27.54 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $17.78 Typical High $17.78 | Professional | 53 · Discontinued | $10.96 | $17.78 | $17.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $13.18 Typical High $13.18 | Professional | 55 · Aftercare only | $8.32 | $13.18 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $8.71 Typical High $8.71 | Professional | 56 · Pre-op care only | $5.50 | $8.71 | $8.71 |
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 $74.13 Median $74.13 Typical High $74.13 | Professional | 12 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 93 · Audio-only telehealth | $74.13 | $74.13 | $74.13 |
Where Alabama sits
The same service costs 2.6 times more in Kansas than in Arizona. 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
$46.77
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.