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 $14.13 | Facility | None | $10.72 | $10.72 | $14.13 |
Aetna Setting Professional Modifier None Typical Low $7.41 Median $10.72 Typical High $10.72 | Professional | None | $7.41 | $10.72 | $10.72 |
Ambetter Setting Professional Modifier None Typical Low $6.17 Median $6.17 Typical High $6.46 | Professional | None | $6.17 | $6.17 | $6.46 |
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 $6.46 Median $7.76 Typical High $9.33 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $6.46 | $7.76 | $9.33 |
Cigna Setting Facility Modifier None Typical Low $7.41 Median $7.76 Typical High $29.51 | Facility | None | $7.41 | $7.76 | $29.51 |
Cigna Setting Professional Modifier None Typical Low $4.68 Median $5.75 Typical High $52.48 | Professional | None | $4.68 | $5.75 | $52.48 |
United Setting Facility Modifier None Typical Low $3.31 Median $8.32 Typical High $30.20 | Facility | None | $3.31 | $8.32 | $30.20 |
United Setting Professional Modifier None Typical Low $3.89 Median $4.57 Typical High $7.59 | Professional | None | $3.89 | $4.57 | $7.59 |
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 $4.07 Median $5.25 Typical High $5.25 | Professional | 52 · Reduced service | $4.07 | $5.25 | $5.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.62 Median $2.14 Typical High $2.14 | Professional | 53 · Discontinued | $1.62 | $2.14 | $2.14 |
Where Alabama sits
The same service costs 3.6 times more in Kansas than in Maryland. 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· 49th 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.