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 Facility Modifier None Typical Low $50.12 Median $67.61 Typical High $89.13 | Facility | None | $50.12 | $67.61 | $89.13 |
Aetna Setting Professional Modifier None Typical Low $50.12 Median $67.61 Typical High $89.13 | Professional | None | $50.12 | $67.61 | $89.13 |
Ambetter Setting Professional Modifier None Typical Low $57.54 Median $107.15 Typical High $131.83 | Professional | None | $57.54 | $107.15 | $131.83 |
BCBS Alabama Setting Professional Modifier None Typical Low $61.66 Median $141.25 Typical High $223.87 | Professional | None | $61.66 | $141.25 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $114.82 Median $134.90 Typical High $151.36 | Facility | None | $114.82 | $134.90 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $74.13 Typical High $102.33 | Professional | None | $63.10 | $74.13 | $102.33 |
United Setting Professional Modifier None Typical Low $58.88 Median $81.28 Typical High $109.65 | Professional | None | $58.88 | $81.28 | $109.65 |
8 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 $33.11 Median $40.74 Typical High $44.67 | Professional | 52 · Reduced service | $33.11 | $40.74 | $44.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $12.02 Typical High $13.49 | Professional | 55 · Aftercare only | $10.00 | $12.02 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $8.13 Typical High $8.91 | Professional | 56 · Pre-op care only | $6.61 | $8.13 | $8.91 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $91.20 Median $107.15 Typical High $131.83 | Professional | 25 · Same-day visit | $91.20 | $107.15 | $131.83 |
Ambetter Setting Professional Modifier 93 · Audio-only telehealth Typical Low $70.79 Median $72.44 Typical High $112.20 | Professional | 93 · Audio-only telehealth | $70.79 | $72.44 | $112.20 |
Ambetter Setting Professional Modifier AF · Specialist physician Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | AF · Specialist physician | $70.79 | $70.79 | $70.79 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | GC · Resident with teaching physician | $67.61 | $67.61 | $67.61 |
BCBS Alabama Setting Professional Modifier 10 Typical Low $64.57 Median $89.13 Typical High $138.04 | Professional | 10 | $64.57 | $89.13 | $138.04 |
Where Alabama sits
The same service costs 2.3 times more in Alaska than in Alabama. 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· 51st of 51
$74.13
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.