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 $20.89 Median $21.38 Typical High $28.84 | Facility | None | $20.89 | $21.38 | $28.84 |
Aetna Setting Professional Modifier None Typical Low $10.00 Median $21.38 Typical High $21.38 | Professional | None | $10.00 | $21.38 | $21.38 |
Ambetter Setting Professional Modifier None Typical Low $9.33 Median $9.33 Typical High $13.18 | Professional | None | $9.33 | $9.33 | $13.18 |
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 $13.18 Median $15.85 Typical High $19.05 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $13.18 | $15.85 | $19.05 |
Cigna Setting Facility Modifier None Typical Low $15.14 Median $15.85 Typical High $60.26 | Facility | None | $15.14 | $15.85 | $60.26 |
Cigna Setting Professional Modifier None Typical Low $9.77 Median $11.75 Typical High $107.15 | Professional | None | $9.77 | $11.75 | $107.15 |
United Setting Facility Modifier None Typical Low $6.76 Median $16.98 Typical High $18.62 | Facility | None | $6.76 | $16.98 | $18.62 |
United Setting Professional Modifier None Typical Low $7.94 Median $10.72 Typical High $15.49 | Professional | None | $7.94 | $10.72 | $15.49 |
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 $8.32 Median $10.72 Typical High $10.72 | Professional | 52 · Reduced service | $8.32 | $10.72 | $10.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.31 Median $4.37 Typical High $4.37 | Professional | 53 · Discontinued | $3.31 | $4.37 | $4.37 |
Where Alabama sits
The same service costs 10.0 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· 33rd 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.