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 Facility Modifier None Typical Low $28.18 Median $28.18 Typical High $28.18 | Facility | None | $28.18 | $28.18 | $28.18 |
Aetna Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | None | $28.18 | $28.18 | $28.18 |
BCBS Alabama Setting Professional Modifier 12 Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | 12 | $28.18 | $28.18 | $28.18 |
Cigna Setting Facility Modifier None Typical Low $28.18 Median $28.84 Typical High $36.31 | Facility | None | $28.18 | $28.84 | $36.31 |
Cigna Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $41.69 | Professional | None | $28.18 | $28.18 | $41.69 |
United Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | None | $24.55 | $24.55 | $24.55 |
4 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 $14.13 Median $14.13 Typical High $14.13 | Professional | 52 · Reduced service | $14.13 | $14.13 | $14.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.62 Median $5.62 Typical High $5.62 | Professional | 53 · Discontinued | $5.62 | $5.62 | $5.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | 55 · Aftercare only | $4.27 | $4.27 | $4.27 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $2.82 Typical High $2.82 | Professional | 56 · Pre-op care only | $2.82 | $2.82 | $2.82 |
Where Alabama sits
The same service costs 2.2 times more in Alaska than in Oklahoma. 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· 19th of 51
$28.18
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.