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 $19.05 Typical High $19.05 | Professional | None | $16.98 | $19.05 | $19.05 |
Cigna Setting Facility Modifier None Typical Low $14.45 Median $14.45 Typical High $14.45 | Facility | None | $14.45 | $14.45 | $14.45 |
Cigna Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $14.45 | Professional | None | $10.47 | $10.47 | $14.45 |
United Setting Facility Modifier None Typical Low $12.59 Median $21.88 Typical High $25.70 | Facility | None | $12.59 | $21.88 | $25.70 |
United Setting Professional Modifier None Typical Low $6.31 Median $11.22 Typical High $14.45 | Professional | None | $6.31 | $11.22 | $14.45 |
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 $9.33 Median $9.55 Typical High $9.55 | Professional | 52 · Reduced service | $9.33 | $9.55 | $9.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.80 Median $3.80 Typical High $3.80 | Professional | 53 · Discontinued | $3.80 | $3.80 | $3.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.82 Median $2.88 Typical High $2.88 | Professional | 55 · Aftercare only | $2.82 | $2.88 | $2.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.91 Median $1.91 Typical High $1.91 | Professional | 56 · Pre-op care only | $1.91 | $1.91 | $1.91 |
BCBS Alabama Setting Professional Modifier 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 Typical Low $17.78 Median $17.78 Typical High $17.78 | Professional | 02 + 10 + 12 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 34 + 41 | $17.78 | $17.78 | $17.78 |
Where Alabama sits
The same service costs 3.0 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· 42nd of 51
$12.02
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.