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 $0.56 Median $0.63 Typical High $0.63 | Professional | None | $0.56 | $0.63 | $0.63 |
Cigna Setting Facility Modifier None Typical Low $0.42 Median $0.42 Typical High $0.42 | Facility | None | $0.42 | $0.42 | $0.42 |
Cigna Setting Professional Modifier None Typical Low $0.36 Median $0.36 Typical High $0.42 | Professional | None | $0.36 | $0.36 | $0.42 |
United Setting Facility Modifier None Typical Low $0.78 Median $0.91 Typical High $0.91 | Facility | None | $0.78 | $0.91 | $0.91 |
United Setting Professional Modifier None Typical Low $0.22 Median $0.37 Typical High $0.50 | Professional | None | $0.22 | $0.37 | $0.50 |
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 $0.32 Median $0.32 Typical High $0.32 | Professional | 52 · Reduced service | $0.32 | $0.32 | $0.32 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.13 Median $0.13 Typical High $0.13 | Professional | 53 · Discontinued | $0.13 | $0.13 | $0.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.09 Median $0.09 Typical High $0.09 | Professional | 55 · Aftercare only | $0.09 | $0.09 | $0.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.06 Median $0.06 Typical High $0.06 | Professional | 56 · Pre-op care only | $0.06 | $0.06 | $0.06 |
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 $0.55 Median $0.55 Typical High $0.55 | Professional | 12 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 55 · Aftercare only + 99 · Multiple modifiers | $0.55 | $0.55 | $0.55 |
Where Alabama sits
The same service costs 2.3 times more in Montana than in Hawaii. 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· 44th of 51
$0.39
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.