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 $95.50 Median $95.50 Typical High $95.50 | Professional | None | $95.50 | $95.50 | $95.50 |
Cigna Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Facility | None | $91.20 | $91.20 | $91.20 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $91.20 | Professional | None | $77.62 | $77.62 | $91.20 |
United Setting Facility Modifier None Typical Low $117.49 Median $138.04 Typical High $138.04 | Facility | None | $117.49 | $138.04 | $138.04 |
United Setting Professional Modifier None Typical Low $33.88 Median $57.54 Typical High $77.62 | Professional | None | $33.88 | $57.54 | $77.62 |
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 $47.86 Median $47.86 Typical High $47.86 | Professional | 52 · Reduced service | $47.86 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $19.05 Typical High $19.05 | Professional | 53 · Discontinued | $19.05 | $19.05 | $19.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $14.45 Typical High $14.45 | Professional | 55 · Aftercare only | $14.45 | $14.45 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $9.55 Typical High $9.55 | Professional | 56 · Pre-op care only | $9.55 | $9.55 | $9.55 |
BCBS Alabama Setting Professional Modifier 12 + 21 + 22 · Increased work + 31 + 32 · Mandated service + 41 + 52 · Reduced service + 93 · Audio-only telehealth Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | 12 + 21 + 22 · Increased work + 31 + 32 · Mandated service + 41 + 52 · Reduced service + 93 · Audio-only telehealth | $85.11 | $85.11 | $85.11 |
Where Alabama sits
The same service costs 1.9 times more in Montana than in Virginia. 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· 27th of 51
$77.62
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.