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 $5.62 Median $5.89 Typical High $9.77 | Facility | None | $5.62 | $5.89 | $9.77 |
Aetna Setting Professional Modifier None Typical Low $4.17 Median $5.89 Typical High $6.46 | Professional | None | $4.17 | $5.89 | $6.46 |
Ambetter Setting Professional Modifier None Typical Low $2.19 Median $2.57 Typical High $6.92 | Professional | None | $2.19 | $2.57 | $6.92 |
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 $3.55 Median $4.27 Typical High $5.25 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $3.55 | $4.27 | $5.25 |
Cigna Setting Facility Modifier None Typical Low $4.17 Median $4.37 Typical High $16.60 | Facility | None | $4.17 | $4.37 | $16.60 |
Cigna Setting Professional Modifier None Typical Low $2.57 Median $3.24 Typical High $28.18 | Professional | None | $2.57 | $3.24 | $28.18 |
United Setting Facility Modifier None Typical Low $1.82 Median $4.57 Typical High $10.47 | Facility | None | $1.82 | $4.57 | $10.47 |
United Setting Professional Modifier None Typical Low $2.14 Median $2.57 Typical High $4.17 | Professional | None | $2.14 | $2.57 | $4.17 |
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 $2.29 Median $2.95 Typical High $2.95 | Professional | 52 · Reduced service | $2.29 | $2.95 | $2.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.91 Median $1.17 Typical High $1.17 | Professional | 53 · Discontinued | $0.91 | $1.17 | $1.17 |
Where Alabama sits
The same service costs 9.5 times more in Minnesota than in New Jersey. 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· 26th of 51
$5.89
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.