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 $85.11 Median $85.11 Typical High $114.82 | Facility | None | $85.11 | $85.11 | $114.82 |
Aetna Setting Professional Modifier None Typical Low $39.81 Median $85.11 Typical High $85.11 | Professional | None | $39.81 | $85.11 | $85.11 |
Ambetter Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $52.48 | Professional | None | $37.15 | $37.15 | $52.48 |
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 $52.48 Median $63.10 Typical High $75.86 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $52.48 | $63.10 | $75.86 |
Cigna Setting Facility Modifier None Typical Low $60.26 Median $63.10 Typical High $239.88 | Facility | None | $60.26 | $63.10 | $239.88 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $45.71 Typical High $426.58 | Professional | None | $38.02 | $45.71 | $426.58 |
United Setting Facility Modifier None Typical Low $26.92 Median $67.61 Typical High $74.13 | Facility | None | $26.92 | $67.61 | $74.13 |
United Setting Professional Modifier None Typical Low $31.62 Median $42.66 Typical High $61.66 | Professional | None | $31.62 | $42.66 | $61.66 |
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 $33.11 Median $42.66 Typical High $42.66 | Professional | 52 · Reduced service | $33.11 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $17.38 Typical High $17.38 | Professional | 53 · Discontinued | $13.18 | $17.38 | $17.38 |
Where Alabama sits
The same service costs 5.4 times more in Alaska 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
$31.62
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.