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 $2.51 Median $2.51 Typical High $3.39 | Facility | None | $2.51 | $2.51 | $3.39 |
Aetna Setting Professional Modifier None Typical Low $1.78 Median $2.51 Typical High $2.51 | Professional | None | $1.78 | $2.51 | $2.51 |
BCBS Alabama Setting Facility Modifier None Typical Low $3.98 Median $3.98 Typical High $3.98 | Facility | None | $3.98 | $3.98 | $3.98 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers Typical Low $1.51 Median $1.82 Typical High $2.19 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $1.51 | $1.82 | $2.19 |
Cigna Setting Facility Modifier None Typical Low $1.78 Median $1.82 Typical High $7.24 | Facility | None | $1.78 | $1.82 | $7.24 |
Cigna Setting Professional Modifier None Typical Low $1.07 Median $1.38 Typical High $12.02 | Professional | None | $1.07 | $1.38 | $12.02 |
United Setting Facility Modifier None Typical Low $0.78 Median $1.95 Typical High $6.03 | Facility | None | $0.78 | $1.95 | $6.03 |
United Setting Professional Modifier None Typical Low $1.29 Median $1.51 Typical High $3.02 | Professional | None | $1.29 | $1.51 | $3.02 |
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 $0.95 Median $1.26 Typical High $1.26 | Professional | 52 · Reduced service | $0.95 | $1.26 | $1.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.38 Median $0.50 Typical High $0.50 | Professional | 53 · Discontinued | $0.38 | $0.50 | $0.50 |
Where Alabama sits
The same service costs 3.2 times more in Kansas than in Washington, DC. 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· 13th of 51
$2.82
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.