How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $37.15 Median $50.12 Typical High $50.12 | Professional | None | $37.15 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $18.62 Median $25.12 Typical High $25.12 | Professional | 52 · Reduced service | $18.62 | $25.12 | $25.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $10.00 Typical High $10.00 | Professional | 53 · Discontinued | $7.41 | $10.00 | $10.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $7.59 Typical High $7.59 | Professional | 55 · Aftercare only | $5.62 | $7.59 | $7.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $5.01 Typical High $5.01 | Professional | 56 · Pre-op care only | $3.72 | $5.01 | $5.01 |
BCBS Alabama Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | None | $39.81 | $39.81 | $39.81 |
Cigna Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | None | $37.15 | $37.15 | $37.15 |
United Setting Facility Modifier None Typical Low $43.65 Median $44.67 Typical High $60.26 | Facility | None | $43.65 | $44.67 | $60.26 |
United Setting Professional Modifier None Typical Low $25.70 Median $35.48 Typical High $42.66 | Professional | None | $25.70 | $35.48 | $42.66 |
1 more rate 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 |
|---|---|---|---|---|---|
BCBS Alabama Setting Professional Modifier 12 Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | 12 | $39.81 | $39.81 | $39.81 |
Where Alabama sits
The same service costs 12.9 times more in Hawaii than in Kentucky. 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· 41st of 51
$37.15
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.