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 $0.65 Median $0.65 Typical High $0.65 | Professional | None | $0.65 | $0.65 | $0.65 |
BCBS Setting Professional Modifier 12 Typical Low $0.65 Median $0.65 Typical High $0.65 | Professional | 12 | $0.65 | $0.65 | $0.65 |
Cigna Setting Facility Modifier None Typical Low $0.65 Median $0.66 Typical High $0.83 | Facility | None | $0.65 | $0.66 | $0.83 |
Cigna Setting Professional Modifier None Typical Low $0.65 Median $0.65 Typical High $2.04 | Professional | None | $0.65 | $0.65 | $2.04 |
United Setting Professional Modifier None Typical Low $0.68 Median $0.68 Typical High $0.68 | Professional | None | $0.68 | $0.68 | $0.68 |
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 $0.32 Median $0.32 Typical High $0.32 | Professional | 52 · Reduced service | $0.32 | $0.32 | $0.32 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.13 Median $0.13 Typical High $0.13 | Professional | 53 · Discontinued | $0.13 | $0.13 | $0.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.10 Median $0.10 Typical High $0.10 | Professional | 55 · Aftercare only | $0.10 | $0.10 | $0.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.06 Median $0.06 Typical High $0.06 | Professional | 56 · Pre-op care only | $0.06 | $0.06 | $0.06 |
Where Alabama sits
The same service costs 2.7 times more in Texas than in Wyoming. 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
$0.66
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.