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 $169.82 Median $169.82 Typical High $229.09 | Facility | None | $169.82 | $169.82 | $229.09 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $169.82 Typical High $169.82 | Professional | None | $131.83 | $169.82 | $169.82 |
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 $95.50 Median $125.89 Typical High $151.36 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $95.50 | $125.89 | $151.36 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $125.89 Typical High $467.74 | Facility | None | $120.23 | $125.89 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $77.62 Typical High $812.83 | Professional | None | $74.13 | $77.62 | $812.83 |
United Setting Facility Modifier None Typical Low $53.70 Median $134.90 Typical High $147.91 | Facility | None | $53.70 | $134.90 | $147.91 |
United Setting Professional Modifier None Typical Low $61.66 Median $74.13 Typical High $120.23 | Professional | None | $61.66 | $74.13 | $120.23 |
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 $66.07 Median $85.11 Typical High $85.11 | Professional | 52 · Reduced service | $66.07 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $33.88 Typical High $33.88 | Professional | 53 · Discontinued | $26.30 | $33.88 | $33.88 |
Where Alabama sits
The same service costs 5.8 times more in Kansas 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
$61.66
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.