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 $4.68 Median $5.25 Typical High $5.25 | Professional | None | $4.68 | $5.25 | $5.25 |
Ambetter Setting Professional Modifier None Typical Low $3.63 Median $4.27 Typical High $5.13 | Professional | None | $3.63 | $4.27 | $5.13 |
BCBS Alabama Setting Facility Modifier None Typical Low $34.67 Median $35.48 Typical High $35.48 | Facility | None | $34.67 | $35.48 | $35.48 |
BCBS Alabama Setting Professional Modifier 10 + 32 · Mandated service Typical Low $5.50 Median $5.62 Typical High $5.62 | Professional | 10 + 32 · Mandated service | $5.50 | $5.62 | $5.62 |
Cigna Setting Professional Modifier None Typical Low $3.02 Median $4.68 Typical High $5.01 | Professional | None | $3.02 | $4.68 | $5.01 |
United Setting Facility Modifier None Typical Low $43.65 Median $44.67 Typical High $60.26 | Facility | None | $43.65 | $44.67 | $60.26 |
United Setting Professional Modifier None Typical Low $3.80 Median $4.79 Typical High $7.08 | Professional | None | $3.80 | $4.79 | $7.08 |
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 $2.29 Median $2.63 Typical High $2.63 | Professional | 52 · Reduced service | $2.29 | $2.63 | $2.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.93 Median $1.05 Typical High $1.05 | Professional | 53 · Discontinued | $0.93 | $1.05 | $1.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.71 Median $0.79 Typical High $0.79 | Professional | 55 · Aftercare only | $0.71 | $0.79 | $0.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.47 Median $0.52 Typical High $0.52 | Professional | 56 · Pre-op care only | $0.47 | $0.52 | $0.52 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $3.63 Median $4.27 Typical High $4.47 | Professional | 59 · Distinct service | $3.63 | $4.27 | $4.47 |
Where Alabama sits
The same service costs 2.7 times more in North Dakota than in New Mexico. 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· 25th of 51
$5.25
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.