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 $0.17 Median $0.17 Typical High $0.17 | Facility | None | $0.17 | $0.17 | $0.17 |
Aetna Setting Professional Modifier None Typical Low $0.18 Median $0.18 Typical High $0.18 | Professional | None | $0.18 | $0.18 | $0.18 |
BCBS Alabama Setting Professional Modifier 12 Typical Low $0.11 Median $0.11 Typical High $0.11 | Professional | 12 | $0.11 | $0.11 | $0.11 |
Cigna Setting Facility Modifier None Typical Low $0.18 Median $0.19 Typical High $0.23 | Facility | None | $0.18 | $0.19 | $0.23 |
Cigna Setting Professional Modifier None Typical Low $0.04 Median $0.18 Typical High $0.18 | Professional | None | $0.04 | $0.18 | $0.18 |
United Setting Professional Modifier None Typical Low $0.18 Median $0.18 Typical High $0.18 | Professional | None | $0.18 | $0.18 | $0.18 |
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 $0.09 Median $0.09 Typical High $0.09 | Professional | 52 · Reduced service | $0.09 | $0.09 | $0.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.04 Median $0.04 Typical High $0.04 | Professional | 53 · Discontinued | $0.04 | $0.04 | $0.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.03 Median $0.03 Typical High $0.03 | Professional | 55 · Aftercare only | $0.03 | $0.03 | $0.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | 56 · Pre-op care only | $0.02 | $0.02 | $0.02 |
Where Alabama sits
The same service costs 8.1 times more in Oklahoma than in Hawaii. 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· 8th of 51
$0.18
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.