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 $1.32 Median $1.45 Typical High $1.45 | Professional | None | $1.32 | $1.45 | $1.45 |
Cigna Setting Facility Modifier None Typical Low $1.10 Median $1.10 Typical High $1.10 | Facility | None | $1.10 | $1.10 | $1.10 |
Cigna Setting Professional Modifier None Typical Low $0.93 Median $0.93 Typical High $1.10 | Professional | None | $0.93 | $0.93 | $1.10 |
United Setting Professional Modifier None Typical Low $0.51 Median $0.85 Typical High $1.12 | Professional | None | $0.51 | $0.85 | $1.12 |
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 $0.72 Median $0.72 Typical High $0.72 | Professional | 52 · Reduced service | $0.72 | $0.72 | $0.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.28 Median $0.28 Typical High $0.28 | Professional | 53 · Discontinued | $0.28 | $0.28 | $0.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.22 Median $0.22 Typical High $0.22 | Professional | 55 · Aftercare only | $0.22 | $0.22 | $0.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.14 Median $0.14 Typical High $0.14 | Professional | 56 · Pre-op care only | $0.14 | $0.14 | $0.14 |
BCBS Alabama Setting Professional Modifier 12 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 93 · Audio-only telehealth Typical Low $1.48 Median $1.48 Typical High $1.48 | Professional | 12 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 32 · Mandated service + 93 · Audio-only telehealth | $1.48 | $1.48 | $1.48 |
Where Alabama sits
The same service costs 2.1 times more in Hawaii 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· 48th of 51
$0.93
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.