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 $64.57 Median $64.57 Typical High $87.10 | Facility | None | $64.57 | $64.57 | $87.10 |
Aetna Setting Professional Modifier None Typical Low $50.12 Median $64.57 Typical High $64.57 | Professional | None | $50.12 | $64.57 | $64.57 |
BCBS Alabama Setting Facility Modifier None Typical Low $46.77 Median $47.86 Typical High $47.86 | Facility | None | $46.77 | $47.86 | $47.86 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers Typical Low $36.31 Median $46.77 Typical High $57.54 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $36.31 | $46.77 | $57.54 |
Cigna Setting Facility Modifier None Typical Low $45.71 Median $46.77 Typical High $177.83 | Facility | None | $45.71 | $46.77 | $177.83 |
Cigna Setting Professional Modifier None Typical Low $23.44 Median $28.18 Typical High $257.04 | Professional | None | $23.44 | $28.18 | $257.04 |
United Setting Facility Modifier None Typical Low $19.95 Median $50.12 Typical High $56.23 | Facility | None | $19.95 | $50.12 | $56.23 |
United Setting Professional Modifier None Typical Low $23.44 Median $29.51 Typical High $45.71 | Professional | None | $23.44 | $29.51 | $45.71 |
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 $25.12 Median $32.36 Typical High $32.36 | Professional | 52 · Reduced service | $25.12 | $32.36 | $32.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $12.88 Typical High $12.88 | Professional | 53 · Discontinued | $10.00 | $12.88 | $12.88 |
Where Alabama sits
The same service costs 4.3 times more in Kansas than in Oklahoma. 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· 36th of 51
$46.77
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.