How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $30.20 Median $37.15 Typical High $43.65 | Facility | None | $30.20 | $37.15 | $43.65 |
Aetna Setting Professional Modifier None Typical Low $30.20 Median $33.88 Typical High $47.86 | Professional | None | $30.20 | $33.88 | $47.86 |
Ambetter Setting Professional Modifier None Typical Low $35.48 Median $42.66 Typical High $58.88 | Professional | None | $35.48 | $42.66 | $58.88 |
BCBS Alabama Setting Professional Modifier None Typical Low $33.88 Median $46.77 Typical High $61.66 | Professional | None | $33.88 | $46.77 | $61.66 |
Cigna Setting Professional Modifier None Typical Low $32.36 Median $33.11 Typical High $53.70 | Professional | None | $32.36 | $33.11 | $53.70 |
United Setting Professional Modifier None Typical Low $29.51 Median $38.02 Typical High $51.29 | Professional | None | $29.51 | $38.02 | $51.29 |
6 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 $18.20 Median $19.95 Typical High $19.95 | Professional | 52 · Reduced service | $18.20 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $6.03 Typical High $6.03 | Professional | 55 · Aftercare only | $5.50 | $6.03 | $6.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $3.98 Typical High $3.98 | Professional | 56 · Pre-op care only | $3.63 | $3.98 | $3.98 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $41.69 Median $41.69 Typical High $43.65 | Professional | 25 · Same-day visit | $41.69 | $41.69 | $43.65 |
Ambetter Setting Professional Modifier FS · Shared visit Typical Low $35.48 Median $35.48 Typical High $56.23 | Professional | FS · Shared visit | $35.48 | $35.48 | $56.23 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $41.69 Median $41.69 Typical High $54.95 | Professional | GC · Resident with teaching physician | $41.69 | $41.69 | $54.95 |
Where Alabama sits
The same service costs 2.7 times more in Alaska than in New Jersey. 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· 49th 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.