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 $4.47 Median $4.47 Typical High $28.18 | Facility | None | $4.47 | $4.47 | $28.18 |
Aetna Setting Professional Modifier None Typical Low $4.47 Median $4.47 Typical High $4.68 | Professional | None | $4.47 | $4.47 | $4.68 |
Ambetter Setting Professional Modifier None Typical Low $4.47 Median $4.47 Typical High $4.47 | Professional | None | $4.47 | $4.47 | $4.47 |
BCBS Alabama Setting Professional Modifier 12 Typical Low $4.47 Median $4.47 Typical High $4.47 | Professional | 12 | $4.47 | $4.47 | $4.47 |
Cigna Setting Facility Modifier None Typical Low $4.47 Median $4.68 Typical High $5.89 | Facility | None | $4.47 | $4.68 | $5.89 |
Cigna Setting Professional Modifier None Typical Low $4.47 Median $4.47 Typical High $4.47 | Professional | None | $4.47 | $4.47 | $4.47 |
United Setting Professional Modifier None Typical Low $4.17 Median $4.17 Typical High $4.17 | Professional | None | $4.17 | $4.17 | $4.17 |
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 $2.24 Median $2.24 Typical High $2.24 | Professional | 52 · Reduced service | $2.24 | $2.24 | $2.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.89 Median $0.89 Typical High $0.89 | Professional | 53 · Discontinued | $0.89 | $0.89 | $0.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.68 Median $0.68 Typical High $0.68 | Professional | 55 · Aftercare only | $0.68 | $0.68 | $0.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.45 Median $0.45 Typical High $0.45 | Professional | 56 · Pre-op care only | $0.45 | $0.45 | $0.45 |
Where Alabama sits
The same service costs 5.9 times more in Texas than in Rhode Island. 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
$4.47
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.