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 $1.20 Median $1.20 Typical High $1.20 | Facility | None | $1.20 | $1.20 | $1.20 |
Aetna Setting Professional Modifier None Typical Low $1.23 Median $1.23 Typical High $1.23 | Professional | None | $1.23 | $1.23 | $1.23 |
BCBS Alabama Setting Professional Modifier 12 Typical Low $1.23 Median $1.23 Typical High $1.23 | Professional | 12 | $1.23 | $1.23 | $1.23 |
Cigna Setting Facility Modifier None Typical Low $1.23 Median $1.26 Typical High $1.58 | Facility | None | $1.23 | $1.26 | $1.58 |
Cigna Setting Professional Modifier None Typical Low $1.23 Median $1.23 Typical High $5.62 | Professional | None | $1.23 | $1.23 | $5.62 |
United Setting Professional Modifier None Typical Low $1.10 Median $1.10 Typical High $1.10 | Professional | None | $1.10 | $1.10 | $1.10 |
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 $0.62 Median $0.62 Typical High $0.62 | Professional | 52 · Reduced service | $0.62 | $0.62 | $0.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.24 Median $0.24 Typical High $0.24 | Professional | 53 · Discontinued | $0.24 | $0.24 | $0.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.18 Median $0.18 Typical High $0.18 | Professional | 55 · Aftercare only | $0.18 | $0.18 | $0.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.12 Median $0.12 Typical High $0.12 | Professional | 56 · Pre-op care only | $0.12 | $0.12 | $0.12 |
Where Alabama sits
The same service costs 3.8 times more in Texas than in Maryland. 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· 39th of 51
$1.23
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.