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 $22.91 Median $22.91 Typical High $28.18 | Facility | None | $22.91 | $22.91 | $28.18 |
Aetna Setting Professional Modifier None Typical Low $16.60 Median $22.91 Typical High $28.18 | Professional | None | $16.60 | $22.91 | $28.18 |
BCBS Alabama Setting Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Facility | None | $53.70 | $53.70 | $53.70 |
Cigna Setting Facility Modifier None Typical Low $16.98 Median $17.78 Typical High $50.12 | Facility | None | $16.98 | $17.78 | $50.12 |
Cigna Setting Professional Modifier None Typical Low $10.96 Median $12.88 Typical High $26.92 | Professional | None | $10.96 | $12.88 | $26.92 |
United Setting Facility Modifier None Typical Low $60.26 Median $63.10 Typical High $83.18 | Facility | None | $60.26 | $63.10 | $83.18 |
United Setting Professional Modifier None Typical Low $13.49 Median $22.39 Typical High $29.51 | Professional | None | $13.49 | $22.39 | $29.51 |
6 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 $8.32 Median $11.48 Typical High $14.13 | Professional | 52 · Reduced service | $8.32 | $11.48 | $14.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.31 Median $4.57 Typical High $5.62 | Professional | 53 · Discontinued | $3.31 | $4.57 | $5.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.51 Median $3.47 Typical High $4.17 | Professional | 55 · Aftercare only | $2.51 | $3.47 | $4.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.66 Median $2.29 Typical High $2.82 | Professional | 56 · Pre-op care only | $1.66 | $2.29 | $2.82 |
Ambetter Setting Professional Modifier XU · Unusual separate service Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | XU · Unusual separate service | $24.55 | $24.55 | $24.55 |
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 $12.59 Typical High $12.59 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $12.59 | $12.59 | $12.59 |
Where Alabama sits
The same service costs 4.5 times more in Alaska than in Florida. 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
$23.44
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.