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 $7.08 Median $7.08 Typical High $9.55 | Facility | None | $7.08 | $7.08 | $9.55 |
Aetna Setting Professional Modifier None Typical Low $4.47 Median $7.08 Typical High $7.08 | Professional | None | $4.47 | $7.08 | $7.08 |
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 $1.62 Median $2.00 Typical High $2.40 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $1.62 | $2.00 | $2.40 |
Cigna Setting Facility Modifier None Typical Low $5.01 Median $5.25 Typical High $19.50 | Facility | None | $5.01 | $5.25 | $19.50 |
Cigna Setting Professional Modifier None Typical Low $2.69 Median $4.27 Typical High $25.70 | Professional | None | $2.69 | $4.27 | $25.70 |
United Setting Facility Modifier None Typical Low $2.24 Median $5.62 Typical High $6.17 | Facility | None | $2.24 | $5.62 | $6.17 |
United Setting Professional Modifier None Typical Low $1.95 Median $3.72 Typical High $6.17 | Professional | None | $1.95 | $3.72 | $6.17 |
3 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 $2.57 Median $3.55 Typical High $3.55 | Professional | 52 · Reduced service | $2.57 | $3.55 | $3.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.02 Median $1.45 Typical High $1.45 | Professional | 53 · Discontinued | $1.02 | $1.45 | $1.45 |
Ambetter Setting Professional Modifier QW · Waived lab test Typical Low $3.09 Median $3.09 Typical High $3.09 | Professional | QW · Waived lab test | $3.09 | $3.09 | $3.09 |
Where Alabama sits
The same service costs 3.5 times more in Alaska 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
$3.98
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.