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 $63.10 Median $70.79 Typical High $70.79 | Professional | None | $63.10 | $70.79 | $70.79 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
Cigna Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $50.12 | Professional | None | $37.15 | $37.15 | $50.12 |
United Setting Facility Modifier None Typical Low $32.36 Median $89.13 Typical High $104.71 | Facility | None | $32.36 | $89.13 | $104.71 |
United Setting Professional Modifier None Typical Low $25.70 Median $42.66 Typical High $58.88 | Professional | None | $25.70 | $42.66 | $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 $35.48 Median $35.48 Typical High $35.48 | Professional | 52 · Reduced service | $35.48 | $35.48 | $35.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $14.45 Typical High $14.45 | Professional | 53 · Discontinued | $14.45 | $14.45 | $14.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $10.72 Typical High $10.72 | Professional | 55 · Aftercare only | $10.72 | $10.72 | $10.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $7.08 Typical High $7.08 | Professional | 56 · Pre-op care only | $7.08 | $7.08 | $7.08 |
BCBS Alabama Setting Professional Modifier 12 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 55 · Aftercare only + 99 · Multiple modifiers Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | 12 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 55 · Aftercare only + 99 · Multiple modifiers | $61.66 | $61.66 | $61.66 |
Where Alabama sits
The same service costs 2.1 times more in Arkansas than in Colorado. 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· 47th of 51
$44.67
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.