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 $0.14 Median $0.14 Typical High $7.76 | Facility | None | $0.14 | $0.14 | $7.76 |
Aetna Setting Professional Modifier None Typical Low $0.14 Median $0.14 Typical High $0.20 | Professional | None | $0.14 | $0.14 | $0.20 |
BCBS Alabama Setting Professional Modifier 12 Typical Low $0.14 Median $0.14 Typical High $0.14 | Professional | 12 | $0.14 | $0.14 | $0.14 |
Cigna Setting Facility Modifier None Typical Low $0.14 Median $0.14 Typical High $0.18 | Facility | None | $0.14 | $0.14 | $0.18 |
Cigna Setting Professional Modifier None Typical Low $0.14 Median $0.14 Typical High $0.21 | Professional | None | $0.14 | $0.14 | $0.21 |
United Setting Professional Modifier None Typical Low $0.17 Median $0.17 Typical High $0.17 | Professional | None | $0.17 | $0.17 | $0.17 |
3 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 $0.07 Median $0.07 Typical High $0.07 | Professional | 52 · Reduced service | $0.07 | $0.07 | $0.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.03 Median $0.03 Typical High $0.03 | Professional | 53 · Discontinued | $0.03 | $0.03 | $0.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | 55 · Aftercare only | $0.02 | $0.02 | $0.02 |
Where Alabama sits
The same service costs 4.4 times more in Michigan than in South Carolina. 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· 49th of 51
$0.14
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.