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 $10.72 Median $10.72 Typical High $14.45 | Facility | None | $10.72 | $10.72 | $14.45 |
Aetna Setting Professional Modifier None Typical Low $7.59 Median $10.72 Typical High $10.72 | Professional | None | $7.59 | $10.72 | $10.72 |
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 $4.79 Median $5.75 Typical High $7.08 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $4.79 | $5.75 | $7.08 |
Cigna Setting Facility Modifier None Typical Low $7.59 Median $7.94 Typical High $29.51 | Facility | None | $7.59 | $7.94 | $29.51 |
Cigna Setting Professional Modifier None Typical Low $3.47 Median $4.27 Typical High $38.90 | Professional | None | $3.47 | $4.27 | $38.90 |
United Setting Facility Modifier None Typical Low $3.39 Median $8.51 Typical High $36.31 | Facility | None | $3.39 | $8.51 | $36.31 |
United Setting Professional Modifier None Typical Low $3.89 Median $4.68 Typical High $5.62 | Professional | None | $3.89 | $4.68 | $5.62 |
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 $3.80 Median $5.37 Typical High $5.37 | Professional | 52 · Reduced service | $3.80 | $5.37 | $5.37 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.51 Median $2.14 Typical High $2.14 | Professional | 53 · Discontinued | $1.51 | $2.14 | $2.14 |
Where Alabama sits
The same service costs 5.9 times more in Kansas than in Nebraska. 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· 46th of 51
$7.08
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.