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 $1.23 Median $1.62 Typical High $1.62 | Facility | None | $1.23 | $1.62 | $1.62 |
Aetna Setting Professional Modifier None Typical Low $1.66 Median $1.66 Typical High $1.74 | Professional | None | $1.66 | $1.66 | $1.74 |
BCBS Alabama Setting Professional Modifier 12 Typical Low $1.66 Median $1.66 Typical High $1.66 | Professional | 12 | $1.66 | $1.66 | $1.66 |
Cigna Setting Facility Modifier None Typical Low $1.66 Median $1.70 Typical High $2.14 | Facility | None | $1.66 | $1.70 | $2.14 |
Cigna Setting Professional Modifier None Typical Low $1.66 Median $1.66 Typical High $3.98 | Professional | None | $1.66 | $1.66 | $3.98 |
United Setting Professional Modifier None Typical Low $1.86 Median $1.86 Typical High $1.86 | Professional | None | $1.86 | $1.86 | $1.86 |
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 $0.83 Median $0.83 Typical High $0.83 | Professional | 52 · Reduced service | $0.83 | $0.83 | $0.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.33 Median $0.33 Typical High $0.33 | Professional | 53 · Discontinued | $0.33 | $0.33 | $0.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.25 Median $0.25 Typical High $0.25 | Professional | 55 · Aftercare only | $0.25 | $0.25 | $0.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.17 Median $0.17 Typical High $0.17 | Professional | 56 · Pre-op care only | $0.17 | $0.17 | $0.17 |
Where Alabama sits
The same service costs 3.2 times more in Texas than in Georgia. 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· 50th of 51
$1.66
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.