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 $16.22 Median $18.62 Typical High $25.12 | Facility | None | $16.22 | $18.62 | $25.12 |
Aetna Setting Professional Modifier None Typical Low $10.96 Median $18.62 Typical High $19.50 | Professional | None | $10.96 | $18.62 | $19.50 |
Ambetter Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $21.88 | Professional | None | $8.13 | $8.13 | $21.88 |
BCBS Alabama Setting Facility Modifier None Typical Low $18.20 Median $18.62 Typical High $18.62 | Facility | None | $18.20 | $18.62 | $18.62 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers Typical Low $11.22 Median $13.80 Typical High $16.60 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $11.22 | $13.80 | $16.60 |
Cigna Setting Facility Modifier None Typical Low $13.18 Median $13.80 Typical High $51.29 | Facility | None | $13.18 | $13.80 | $51.29 |
Cigna Setting Professional Modifier None Typical Low $8.32 Median $10.23 Typical High $93.33 | Professional | None | $8.32 | $10.23 | $93.33 |
United Setting Facility Modifier None Typical Low $5.89 Median $14.79 Typical High $104.71 | Facility | None | $5.89 | $14.79 | $104.71 |
United Setting Professional Modifier None Typical Low $6.92 Median $9.33 Typical High $13.18 | Professional | None | $6.92 | $9.33 | $13.18 |
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 $7.24 Median $9.33 Typical High $9.33 | Professional | 52 · Reduced service | $7.24 | $9.33 | $9.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.88 Median $3.72 Typical High $3.72 | Professional | 53 · Discontinued | $2.88 | $3.72 | $3.72 |
Where Alabama sits
The same service costs 8.5 times more in Vermont 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· 24th of 51
$18.20
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.