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 $2.69 Median $3.80 Typical High $3.80 | Professional | None | $2.69 | $3.80 | $3.80 |
Ambetter Setting Professional Modifier None Typical Low $3.02 Median $4.79 Typical High $4.79 | Professional | None | $3.02 | $4.79 | $4.79 |
Cigna Setting Facility Modifier None Typical Low $2.69 Median $2.82 Typical High $2.82 | Facility | None | $2.69 | $2.82 | $2.82 |
Cigna Setting Professional Modifier None Typical Low $2.40 Median $2.40 Typical High $2.82 | Professional | None | $2.40 | $2.40 | $2.82 |
United Setting Professional Modifier None Typical Low $1.35 Median $2.19 Typical High $2.88 | Professional | None | $1.35 | $2.19 | $2.88 |
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 $1.91 Median $1.91 Typical High $1.91 | Professional | 52 · Reduced service | $1.91 | $1.91 | $1.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.76 Median $0.76 Typical High $0.76 | Professional | 53 · Discontinued | $0.76 | $0.76 | $0.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.56 Median $0.56 Typical High $0.56 | Professional | 55 · Aftercare only | $0.56 | $0.56 | $0.56 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.38 Median $0.38 Typical High $0.38 | Professional | 56 · Pre-op care only | $0.38 | $0.38 | $0.38 |
BCBS Alabama Setting Professional Modifier 12 + 21 + 22 · Increased work + 31 + 32 · Mandated service + 41 + 52 · Reduced service + 93 · Audio-only telehealth Typical Low $3.89 Median $3.89 Typical High $3.89 | Professional | 12 + 21 + 22 · Increased work + 31 + 32 · Mandated service + 41 + 52 · Reduced service + 93 · Audio-only telehealth | $3.89 | $3.89 | $3.89 |
Where Alabama sits
The same service costs 2.2 times more in Kansas 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
$2.40
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.