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 $18.20 Median $20.89 Typical High $20.89 | Facility | None | $18.20 | $20.89 | $20.89 |
Aetna Setting Professional Modifier None Typical Low $13.18 Median $20.89 Typical High $20.89 | Professional | None | $13.18 | $20.89 | $20.89 |
Ambetter Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $12.59 | Professional | None | $12.02 | $12.02 | $12.59 |
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 $12.59 Median $15.14 Typical High $18.62 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $12.59 | $15.14 | $18.62 |
Cigna Setting Facility Modifier None Typical Low $14.79 Median $15.14 Typical High $57.54 | Facility | None | $14.79 | $15.14 | $57.54 |
Cigna Setting Professional Modifier None Typical Low $9.33 Median $10.96 Typical High $102.33 | Professional | None | $9.33 | $10.96 | $102.33 |
United Setting Facility Modifier None Typical Low $6.46 Median $16.22 Typical High $18.20 | Facility | None | $6.46 | $16.22 | $18.20 |
United Setting Professional Modifier None Typical Low $7.59 Median $9.33 Typical High $14.79 | Professional | None | $7.59 | $9.33 | $14.79 |
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 $7.94 Median $10.47 Typical High $10.47 | Professional | 52 · Reduced service | $7.94 | $10.47 | $10.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.24 Median $4.17 Typical High $4.17 | Professional | 53 · Discontinued | $3.24 | $4.17 | $4.17 |
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· 38th 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.