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 $0.23 Median $0.44 Typical High $0.44 | Facility | None | $0.23 | $0.44 | $0.44 |
Aetna Setting Professional Modifier None Typical Low $0.44 Median $0.44 Typical High $0.47 | Professional | None | $0.44 | $0.44 | $0.47 |
BCBS Alabama Setting Professional Modifier 12 + 21 + 22 · Increased work + 31 + 32 · Mandated service + 52 · Reduced service + 93 · Audio-only telehealth Typical Low $3.72 Median $3.72 Typical High $3.72 | Professional | 12 + 21 + 22 · Increased work + 31 + 32 · Mandated service + 52 · Reduced service + 93 · Audio-only telehealth | $3.72 | $3.72 | $3.72 |
Cigna Setting Facility Modifier None Typical Low $0.44 Median $0.45 Typical High $0.56 | Facility | None | $0.44 | $0.45 | $0.56 |
Cigna Setting Professional Modifier None Typical Low $0.44 Median $0.44 Typical High $0.54 | Professional | None | $0.44 | $0.44 | $0.54 |
United Setting Professional Modifier None Typical Low $0.18 Median $0.44 Typical High $0.44 | Professional | None | $0.18 | $0.44 | $0.44 |
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 $0.22 Median $0.22 Typical High $0.24 | Professional | 52 · Reduced service | $0.22 | $0.22 | $0.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.09 Median $0.09 Typical High $0.09 | Professional | 53 · Discontinued | $0.09 | $0.09 | $0.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.07 Median $0.07 Typical High $0.07 | Professional | 55 · Aftercare only | $0.07 | $0.07 | $0.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.04 Median $0.04 Typical High $0.05 | Professional | 56 · Pre-op care only | $0.04 | $0.04 | $0.05 |
Where Alabama sits
The same service costs 1.6 times more in Alaska than in Montana. 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· 28th of 51
$0.44
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.