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 Professional Modifier None Typical Low $0.79 Median $0.79 Typical High $0.79 | Professional | None | $0.79 | $0.79 | $0.79 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.40 Median $0.40 Typical High $0.40 | Professional | 52 · Reduced service | $0.40 | $0.40 | $0.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.16 Median $0.16 Typical High $0.16 | Professional | 53 · Discontinued | $0.16 | $0.16 | $0.16 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.12 Median $0.12 Typical High $0.12 | Professional | 55 · Aftercare only | $0.12 | $0.12 | $0.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.08 Median $0.08 Typical High $0.08 | Professional | 56 · Pre-op care only | $0.08 | $0.08 | $0.08 |
Cigna Setting Facility Modifier None Typical Low $0.79 Median $0.81 Typical High $1.05 | Facility | None | $0.79 | $0.81 | $1.05 |
Cigna Setting Professional Modifier None Typical Low $0.79 Median $0.79 Typical High $0.79 | Professional | None | $0.79 | $0.79 | $0.79 |
United Setting Professional Modifier None Typical Low $0.63 Median $0.79 Typical High $0.83 | Professional | None | $0.63 | $0.79 | $0.83 |
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 |
|---|---|---|---|---|---|
BCBS Alabama Setting Professional Modifier 12 Typical Low $0.79 Median $0.79 Typical High $0.79 | Professional | 12 | $0.79 | $0.79 | $0.79 |
BCBS Alabama Setting Professional Modifier 24 · Unrelated visit after surgery Typical Low $0.79 Median $0.79 Typical High $0.79 | Professional | 24 · Unrelated visit after surgery | $0.79 | $0.79 | $0.79 |
Where Alabama sits
Rates are fairly even across states for this service. 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· 29th of 51
$0.79
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.