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 $13.49 Median $15.49 Typical High $20.89 | Facility | None | $13.49 | $15.49 | $20.89 |
Aetna Setting Professional Modifier None Typical Low $8.91 Median $15.49 Typical High $15.49 | Professional | None | $8.91 | $15.49 | $15.49 |
Ambetter Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $9.33 | Professional | None | $8.13 | $8.13 | $9.33 |
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 $9.33 Median $11.48 Typical High $13.80 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $9.33 | $11.48 | $13.80 |
Cigna Setting Facility Modifier None Typical Low $10.96 Median $11.48 Typical High $43.65 | Facility | None | $10.96 | $11.48 | $43.65 |
Cigna Setting Professional Modifier None Typical Low $7.08 Median $8.51 Typical High $77.62 | Professional | None | $7.08 | $8.51 | $77.62 |
United Setting Facility Modifier None Typical Low $4.90 Median $12.30 Typical High $13.49 | Facility | None | $4.90 | $12.30 | $13.49 |
United Setting Professional Modifier None Typical Low $5.75 Median $7.76 Typical High $10.96 | Professional | None | $5.75 | $7.76 | $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 $6.03 Median $7.76 Typical High $7.76 | Professional | 52 · Reduced service | $6.03 | $7.76 | $7.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.40 Median $3.09 Typical High $3.09 | Professional | 53 · Discontinued | $2.40 | $3.09 | $3.09 |
Where Alabama sits
The same service costs 3.9 times more in Kansas than in New Jersey. 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· 21st 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.