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 $4.90 Median $5.75 Typical High $5.75 | Facility | None | $4.90 | $5.75 | $5.75 |
Aetna Setting Professional Modifier None Typical Low $3.31 Median $5.75 Typical High $5.75 | Professional | None | $3.31 | $5.75 | $5.75 |
Ambetter Setting Professional Modifier None Typical Low $2.45 Median $2.75 Typical High $6.61 | Professional | None | $2.45 | $2.75 | $6.61 |
BCBS Alabama Setting Facility Modifier None Typical Low $7.08 Median $7.08 Typical High $7.08 | Facility | None | $7.08 | $7.08 | $7.08 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers Typical Low $3.47 Median $4.17 Typical High $5.01 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $3.47 | $4.17 | $5.01 |
Cigna Setting Facility Modifier None Typical Low $4.07 Median $4.17 Typical High $15.49 | Facility | None | $4.07 | $4.17 | $15.49 |
Cigna Setting Professional Modifier None Typical Low $2.57 Median $3.09 Typical High $28.18 | Professional | None | $2.57 | $3.09 | $28.18 |
United Setting Facility Modifier None Typical Low $1.38 Median $4.47 Typical High $10.47 | Facility | None | $1.38 | $4.47 | $10.47 |
United Setting Professional Modifier None Typical Low $2.09 Median $2.45 Typical High $4.07 | Professional | None | $2.09 | $2.45 | $4.07 |
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 $2.19 Median $2.82 Typical High $2.82 | Professional | 52 · Reduced service | $2.19 | $2.82 | $2.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.87 Median $1.12 Typical High $1.12 | Professional | 53 · Discontinued | $0.87 | $1.12 | $1.12 |
Where Alabama sits
The same service costs 9.3 times more in Vermont than in Georgia. 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· 19th of 51
$5.75
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.