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 $51.29 Typical High $74.13 | Professional | None | $51.29 | $51.29 | $74.13 |
Ambetter Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $44.67 | Professional | None | $38.90 | $38.90 | $44.67 |
BCBS Alabama Setting Facility Modifier None Typical Low $38.90 Median $39.81 Typical High $39.81 | Facility | None | $38.90 | $39.81 | $39.81 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $54.95 Typical High $69.18 | Facility | None | $53.70 | $54.95 | $69.18 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $53.70 Typical High $53.70 | Professional | None | $51.29 | $53.70 | $53.70 |
United Setting Professional Modifier None Typical Low $46.77 Median $52.48 Typical High $57.54 | Professional | None | $46.77 | $52.48 | $57.54 |
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 $25.70 Median $25.70 Typical High $25.70 | Professional | 52 · Reduced service | $25.70 | $25.70 | $25.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $10.23 Typical High $10.23 | Professional | 53 · Discontinued | $10.23 | $10.23 | $10.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $7.59 Typical High $7.59 | Professional | 55 · Aftercare only | $7.59 | $7.59 | $7.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $5.13 Typical High $5.13 | Professional | 56 · Pre-op care only | $5.13 | $5.13 | $5.13 |
BCBS Alabama Setting Professional Modifier 12 + 32 · Mandated service Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | 12 + 32 · Mandated service | $47.86 | $47.86 | $47.86 |
Where Alabama sits
The same service costs 1.5 times more in Colorado than in Alaska. 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· 50th of 51
$39.81
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.