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 $13.80 Median $13.80 Typical High $16.22 | Facility | None | $13.80 | $13.80 | $16.22 |
Aetna Setting Professional Modifier None Typical Low $16.22 Median $16.22 Typical High $18.62 | Professional | None | $16.22 | $16.22 | $18.62 |
BCBS Alabama Setting Professional Modifier 12 Typical Low $16.22 Median $16.22 Typical High $39.81 | Professional | 12 | $16.22 | $16.22 | $39.81 |
Cigna Setting Facility Modifier None Typical Low $16.22 Median $16.60 Typical High $26.30 | Facility | None | $16.22 | $16.60 | $26.30 |
Cigna Setting Professional Modifier None Typical Low $16.22 Median $16.22 Typical High $16.22 | Professional | None | $16.22 | $16.22 | $16.22 |
United Setting Facility Modifier None Typical Low $16.22 Median $16.22 Typical High $16.22 | Facility | None | $16.22 | $16.22 | $16.22 |
United Setting Professional Modifier None Typical Low $13.80 Median $13.80 Typical High $14.45 | Professional | None | $13.80 | $13.80 | $14.45 |
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 $8.13 Median $8.13 Typical High $8.13 | Professional | 52 · Reduced service | $8.13 | $8.13 | $8.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.24 Median $3.24 Typical High $3.24 | Professional | 53 · Discontinued | $3.24 | $3.24 | $3.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.40 Median $2.40 Typical High $2.40 | Professional | 55 · Aftercare only | $2.40 | $2.40 | $2.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.62 Median $1.62 Typical High $1.62 | Professional | 56 · Pre-op care only | $1.62 | $1.62 | $1.62 |
Where Alabama sits
The same service costs 5.9 times more in Wyoming than in North Dakota. 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· 44th of 51
$16.22
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.