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 $13.18 Median $15.14 Typical High $15.14 | Facility | None | $13.18 | $15.14 | $15.14 |
Aetna Setting Professional Modifier None Typical Low $7.08 Median $15.14 Typical High $15.14 | Professional | None | $7.08 | $15.14 | $15.14 |
Ambetter Setting Professional Modifier None Typical Low $8.91 Median $8.91 Typical High $9.12 | Professional | None | $8.91 | $8.91 | $9.12 |
BCBS Alabama Setting Facility Modifier None Typical Low $15.14 Median $15.49 Typical High $15.49 | Facility | None | $15.14 | $15.49 | $15.49 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers Typical Low $9.12 Median $11.22 Typical High $13.49 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $9.12 | $11.22 | $13.49 |
Cigna Setting Facility Modifier None Typical Low $10.72 Median $11.22 Typical High $42.66 | Facility | None | $10.72 | $11.22 | $42.66 |
Cigna Setting Professional Modifier None Typical Low $6.76 Median $7.94 Typical High $74.13 | Professional | None | $6.76 | $7.94 | $74.13 |
United Setting Facility Modifier None Typical Low $4.79 Median $12.02 Typical High $13.18 | Facility | None | $4.79 | $12.02 | $13.18 |
United Setting Professional Modifier None Typical Low $5.62 Median $7.59 Typical High $10.96 | Professional | None | $5.62 | $7.59 | $10.96 |
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 $5.89 Median $7.59 Typical High $7.59 | Professional | 52 · Reduced service | $5.89 | $7.59 | $7.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.34 Median $3.02 Typical High $3.02 | Professional | 53 · Discontinued | $2.34 | $3.02 | $3.02 |
Where Alabama sits
The same service costs 4.2 times more in Alaska than in Georgia. 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· 18th of 51
$15.14
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.