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 $25.12 Median $26.30 Typical High $26.30 | Facility | None | $25.12 | $26.30 | $26.30 |
Aetna Setting Professional Modifier None Typical Low $12.02 Median $26.30 Typical High $26.30 | Professional | None | $12.02 | $26.30 | $26.30 |
Ambetter Setting Professional Modifier None Typical Low $7.59 Median $13.80 Typical High $30.90 | Professional | None | $7.59 | $13.80 | $30.90 |
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 $12.02 Median $14.45 Typical High $17.38 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $12.02 | $14.45 | $17.38 |
Cigna Setting Facility Modifier None Typical Low $18.20 Median $19.50 Typical High $72.44 | Facility | None | $18.20 | $19.50 | $72.44 |
Cigna Setting Professional Modifier None Typical Low $10.00 Median $12.88 Typical High $33.11 | Professional | None | $10.00 | $12.88 | $33.11 |
United Setting Facility Modifier None Typical Low $8.32 Median $20.89 Typical High $22.91 | Facility | None | $8.32 | $20.89 | $22.91 |
United Setting Professional Modifier None Typical Low $9.55 Median $11.48 Typical High $13.80 | Professional | None | $9.55 | $11.48 | $13.80 |
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 $9.33 Median $13.18 Typical High $13.18 | Professional | 52 · Reduced service | $9.33 | $13.18 | $13.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.80 Median $5.25 Typical High $5.25 | Professional | 53 · Discontinued | $3.80 | $5.25 | $5.25 |
Where Alabama sits
The same service costs 9.8 times more in Vermont than in Kentucky. 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· 43rd 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.