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 $3.39 Median $3.39 Typical High $3.39 | Facility | None | $3.39 | $3.39 | $3.39 |
Aetna Setting Professional Modifier None Typical Low $3.39 Median $3.39 Typical High $5.01 | Professional | None | $3.39 | $3.39 | $5.01 |
BCBS Alabama Setting Professional Modifier 12 Typical Low $3.39 Median $3.39 Typical High $3.39 | Professional | 12 | $3.39 | $3.39 | $3.39 |
Cigna Setting Facility Modifier None Typical Low $3.39 Median $3.47 Typical High $5.50 | Facility | None | $3.39 | $3.47 | $5.50 |
Cigna Setting Professional Modifier None Typical Low $3.39 Median $3.39 Typical High $22.91 | Professional | None | $3.39 | $3.39 | $22.91 |
United Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $32.36 | Professional | None | $30.90 | $30.90 | $32.36 |
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 $1.70 Median $1.70 Typical High $1.70 | Professional | 52 · Reduced service | $1.70 | $1.70 | $1.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.68 Median $0.68 Typical High $0.68 | Professional | 53 · Discontinued | $0.68 | $0.68 | $0.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.50 Median $0.50 Typical High $0.50 | Professional | 55 · Aftercare only | $0.50 | $0.50 | $0.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.34 Median $0.34 Typical High $0.34 | Professional | 56 · Pre-op care only | $0.34 | $0.34 | $0.34 |
Where Alabama sits
The same service costs 9.1 times more in Rhode Island than in Florida. 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
$3.47
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.