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 $6.03 Median $6.03 Typical High $6.03 | Professional | None | $6.03 | $6.03 | $6.03 |
BCBS Alabama Setting Professional Modifier 12 Typical Low $5.89 Median $5.89 Typical High $5.89 | Professional | 12 | $5.89 | $5.89 | $5.89 |
Cigna Setting Facility Modifier None Typical Low $6.17 Median $6.31 Typical High $7.94 | Facility | None | $6.17 | $6.31 | $7.94 |
Cigna Setting Professional Modifier None Typical Low $6.17 Median $6.17 Typical High $11.75 | Professional | None | $6.17 | $6.17 | $11.75 |
United Setting Professional Modifier None Typical Low $12.30 Median $12.30 Typical High $12.88 | Professional | None | $12.30 | $12.30 | $12.88 |
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 $3.02 Median $3.02 Typical High $3.02 | Professional | 52 · Reduced service | $3.02 | $3.02 | $3.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.20 Median $1.20 Typical High $1.20 | Professional | 53 · Discontinued | $1.20 | $1.20 | $1.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.89 Median $0.89 Typical High $0.89 | Professional | 55 · Aftercare only | $0.89 | $0.89 | $0.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.60 Median $0.60 Typical High $0.60 | Professional | 56 · Pre-op care only | $0.60 | $0.60 | $0.60 |
Where Alabama sits
The same service costs 2.1 times more in Iowa than in Montana. 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· 33rd of 51
$6.31
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.