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 $1.74 Median $2.29 Typical High $2.29 | Professional | None | $1.74 | $2.29 | $2.29 |
Cigna Setting Facility Modifier None Typical Low $1.74 Median $1.74 Typical High $2.14 | Facility | None | $1.74 | $1.74 | $2.14 |
Cigna Setting Professional Modifier None Typical Low $1.48 Median $1.48 Typical High $1.74 | Professional | None | $1.48 | $1.48 | $1.74 |
United Setting Professional Modifier None Typical Low $0.81 Median $1.35 Typical High $1.78 | Professional | None | $0.81 | $1.35 | $1.78 |
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 $1.15 Median $1.15 Typical High $1.15 | Professional | 52 · Reduced service | $1.15 | $1.15 | $1.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.46 Median $0.46 Typical High $0.46 | Professional | 53 · Discontinued | $0.46 | $0.46 | $0.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.35 Median $0.35 Typical High $0.35 | Professional | 55 · Aftercare only | $0.35 | $0.35 | $0.35 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.23 Median $0.23 Typical High $0.23 | Professional | 56 · Pre-op care only | $0.23 | $0.23 | $0.23 |
BCBS Alabama Setting Professional Modifier 12 + 21 + 22 · Increased work + 31 + 32 · Mandated service + 41 + 52 · Reduced service + 93 · Audio-only telehealth Typical Low $2.29 Median $2.29 Typical High $2.29 | Professional | 12 + 21 + 22 · Increased work + 31 + 32 · Mandated service + 41 + 52 · Reduced service + 93 · Audio-only telehealth | $2.29 | $2.29 | $2.29 |
Where Alabama sits
The same service costs 2.2 times more in Kansas 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
$1.48
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.