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 $5.01 Median $5.01 Typical High $5.01 | Facility | None | $5.01 | $5.01 | $5.01 |
Aetna Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | None | $4.27 | $4.27 | $4.27 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $2.14 Median $2.14 Typical High $2.14 | Professional | 52 · Reduced service | $2.14 | $2.14 | $2.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.85 Median $0.85 Typical High $0.85 | Professional | 53 · Discontinued | $0.85 | $0.85 | $0.85 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.65 Median $0.65 Typical High $0.65 | Professional | 55 · Aftercare only | $0.65 | $0.65 | $0.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.43 Median $0.43 Typical High $0.43 | Professional | 56 · Pre-op care only | $0.43 | $0.43 | $0.43 |
Ambetter Setting Professional Modifier None Typical Low $5.50 Median $5.50 Typical High $5.50 | Professional | None | $5.50 | $5.50 | $5.50 |
Cigna Setting Facility Modifier None Typical Low $4.27 Median $4.47 Typical High $6.92 | Facility | None | $4.27 | $4.47 | $6.92 |
Cigna Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | None | $4.27 | $4.27 | $4.27 |
United Setting Professional Modifier None Typical Low $3.98 Median $5.01 Typical High $5.25 | Professional | None | $3.98 | $5.01 | $5.25 |
2 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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $5.25 Median $5.25 Typical High $5.25 | Professional | JZ · No drug discarded | $5.25 | $5.25 | $5.25 |
BCBS Alabama Setting Professional Modifier 32 · Mandated service Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | 32 · Mandated service | $4.27 | $4.27 | $4.27 |
Where Alabama sits
The same service costs 5.1 times more in Wyoming than in Alabama. 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· 51st of 51
$4.27
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.