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 $3.72 Median $4.17 Typical High $4.17 | Professional | None | $3.72 | $4.17 | $4.17 |
Ambetter Setting Professional Modifier None Typical Low $3.16 Median $3.16 Typical High $3.16 | Professional | None | $3.16 | $3.16 | $3.16 |
Cigna Setting Facility Modifier None Typical Low $3.16 Median $3.16 Typical High $3.63 | Facility | None | $3.16 | $3.16 | $3.63 |
Cigna Setting Professional Modifier None Typical Low $2.63 Median $2.63 Typical High $3.16 | Professional | None | $2.63 | $2.63 | $3.16 |
United Setting Professional Modifier None Typical Low $1.48 Median $2.40 Typical High $3.16 | Professional | None | $1.48 | $2.40 | $3.16 |
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 $2.09 Median $2.09 Typical High $2.09 | Professional | 52 · Reduced service | $2.09 | $2.09 | $2.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.83 Median $0.83 Typical High $0.83 | Professional | 53 · Discontinued | $0.83 | $0.83 | $0.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.63 Median $0.63 Typical High $0.63 | Professional | 55 · Aftercare only | $0.63 | $0.63 | $0.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.42 Median $0.42 Typical High $0.42 | Professional | 56 · Pre-op care only | $0.42 | $0.42 | $0.42 |
BCBS Alabama Setting Professional Modifier 12 + 21 + 22 · Increased work + 31 + 32 · Mandated service + 41 + 52 · Reduced service + 93 · Audio-only telehealth Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | 12 + 21 + 22 · Increased work + 31 + 32 · Mandated service + 41 + 52 · Reduced service + 93 · Audio-only telehealth | $4.27 | $4.27 | $4.27 |
Where Alabama sits
The same service costs 2.1 times more in Hawaii than in Connecticut. 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
$2.63
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.