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 $2.82 Median $3.09 Typical High $3.09 | Professional | None | $2.82 | $3.09 | $3.09 |
Cigna Setting Facility Modifier None Typical Low $2.34 Median $2.34 Typical High $2.51 | Facility | None | $2.34 | $2.34 | $2.51 |
Cigna Setting Professional Modifier None Typical Low $2.00 Median $2.00 Typical High $2.34 | Professional | None | $2.00 | $2.00 | $2.34 |
United Setting Professional Modifier None Typical Low $1.10 Median $1.82 Typical High $2.34 | Professional | None | $1.10 | $1.82 | $2.34 |
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 $1.55 Median $1.55 Typical High $1.55 | Professional | 52 · Reduced service | $1.55 | $1.55 | $1.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.62 Median $0.62 Typical High $0.62 | Professional | 53 · Discontinued | $0.62 | $0.62 | $0.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.47 Median $0.47 Typical High $0.47 | Professional | 55 · Aftercare only | $0.47 | $0.47 | $0.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.31 Median $0.31 Typical High $0.31 | Professional | 56 · Pre-op care only | $0.31 | $0.31 | $0.31 |
BCBS Alabama Setting Professional Modifier 12 + 21 + 22 · Increased work + 31 + 32 · Mandated service + 41 + 52 · Reduced service + 93 · Audio-only telehealth Typical Low $3.16 Median $3.16 Typical High $3.16 | Professional | 12 + 21 + 22 · Increased work + 31 + 32 · Mandated service + 41 + 52 · Reduced service + 93 · Audio-only telehealth | $3.16 | $3.16 | $3.16 |
Where Alabama sits
The same service costs 2.2 times more in Kansas than in Delaware. 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
$2.00
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.