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 $29.51 Median $33.88 Typical High $47.86 | Facility | None | $29.51 | $33.88 | $47.86 |
Aetna Setting Professional Modifier None Typical Low $19.50 Median $33.88 Typical High $35.48 | Professional | None | $19.50 | $33.88 | $35.48 |
Ambetter Setting Professional Modifier None Typical Low $12.59 Median $14.79 Typical High $38.02 | Professional | None | $12.59 | $14.79 | $38.02 |
BCBS Alabama Setting Facility Modifier None Typical Low $17.78 Median $17.78 Typical High $17.78 | Facility | None | $17.78 | $17.78 | $17.78 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers Typical Low $20.42 Median $25.12 Typical High $30.20 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $20.42 | $25.12 | $30.20 |
Cigna Setting Facility Modifier None Typical Low $23.99 Median $25.12 Typical High $95.50 | Facility | None | $23.99 | $25.12 | $95.50 |
Cigna Setting Professional Modifier None Typical Low $15.14 Median $18.62 Typical High $169.82 | Professional | None | $15.14 | $18.62 | $169.82 |
United Setting Facility Modifier None Typical Low $10.72 Median $26.92 Typical High $29.51 | Facility | None | $10.72 | $26.92 | $29.51 |
United Setting Professional Modifier None Typical Low $12.30 Median $16.98 Typical High $23.99 | Professional | None | $12.30 | $16.98 | $23.99 |
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 $13.18 Median $16.98 Typical High $16.98 | Professional | 52 · Reduced service | $13.18 | $16.98 | $16.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.25 Median $6.76 Typical High $6.76 | Professional | 53 · Discontinued | $5.25 | $6.76 | $6.76 |
Where Alabama sits
The same service costs 6.8 times more in Vermont 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
$17.78
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.