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 $7.41 Median $7.41 Typical High $10.00 | Facility | None | $7.41 | $7.41 | $10.00 |
Aetna Setting Professional Modifier None Typical Low $3.47 Median $7.41 Typical High $7.41 | Professional | None | $3.47 | $7.41 | $7.41 |
Ambetter Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $4.47 | Professional | None | $4.27 | $4.27 | $4.47 |
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 $4.07 Median $4.90 Typical High $5.89 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $4.07 | $4.90 | $5.89 |
Cigna Setting Facility Modifier None Typical Low $5.25 Median $5.50 Typical High $20.42 | Facility | None | $5.25 | $5.50 | $20.42 |
Cigna Setting Professional Modifier None Typical Low $3.39 Median $3.98 Typical High $37.15 | Professional | None | $3.39 | $3.98 | $37.15 |
United Setting Facility Modifier None Typical Low $2.34 Median $5.75 Typical High $6.46 | Facility | None | $2.34 | $5.75 | $6.46 |
United Setting Professional Modifier None Typical Low $2.69 Median $3.24 Typical High $4.79 | Professional | None | $2.69 | $3.24 | $4.79 |
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 $2.88 Median $3.72 Typical High $3.72 | Professional | 52 · Reduced service | $2.88 | $3.72 | $3.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.15 Median $1.48 Typical High $1.48 | Professional | 53 · Discontinued | $1.15 | $1.48 | $1.48 |
Where Alabama sits
The same service costs 3.0 times more in Alaska 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· 21st 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.