How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $9.55 Median $10.00 Typical High $10.47 | Facility | None | $9.55 | $10.00 | $10.47 |
Aetna Setting Professional Modifier None Typical Low $5.75 Median $10.00 Typical High $10.23 | Professional | None | $5.75 | $10.00 | $10.23 |
Ambetter Setting Professional Modifier None Typical Low $4.37 Median $4.37 Typical High $6.03 | Professional | None | $4.37 | $4.37 | $6.03 |
BCBS Alabama Setting Facility Modifier None Typical Low $12.02 Median $12.02 Typical High $12.02 | Facility | None | $12.02 | $12.02 | $12.02 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers Typical Low $6.03 Median $7.24 Typical High $8.91 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $6.03 | $7.24 | $8.91 |
Cigna Setting Facility Modifier None Typical Low $7.08 Median $7.41 Typical High $27.54 | Facility | None | $7.08 | $7.41 | $27.54 |
Cigna Setting Professional Modifier None Typical Low $4.47 Median $5.37 Typical High $48.98 | Professional | None | $4.47 | $5.37 | $48.98 |
United Setting Facility Modifier None Typical Low $3.09 Median $7.76 Typical High $8.71 | Facility | None | $3.09 | $7.76 | $8.71 |
United Setting Professional Modifier None Typical Low $3.63 Median $4.37 Typical High $7.08 | Professional | None | $3.63 | $4.37 | $7.08 |
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 |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $3.89 Median $5.01 Typical High $5.01 | Professional | 52 · Reduced service | $3.89 | $5.01 | $5.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.55 Median $2.00 Typical High $2.00 | Professional | 53 · Discontinued | $1.55 | $2.00 | $2.00 |
Where Alabama sits
The same service costs 10.5 times more in Vermont than in Maryland. 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· 24th of 51
$10.00
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.