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 $28.18 Median $32.36 Typical High $42.66 | Facility | None | $28.18 | $32.36 | $42.66 |
Aetna Setting Professional Modifier None Typical Low $18.62 Median $32.36 Typical High $33.88 | Professional | None | $18.62 | $32.36 | $33.88 |
Ambetter Setting Professional Modifier None Typical Low $11.75 Median $14.13 Typical High $38.02 | Professional | None | $11.75 | $14.13 | $38.02 |
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 $19.50 Median $23.44 Typical High $28.84 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $19.50 | $23.44 | $28.84 |
Cigna Setting Facility Modifier None Typical Low $22.91 Median $23.44 Typical High $89.13 | Facility | None | $22.91 | $23.44 | $89.13 |
Cigna Setting Professional Modifier None Typical Low $14.13 Median $17.38 Typical High $158.49 | Professional | None | $14.13 | $17.38 | $158.49 |
United Setting Facility Modifier None Typical Low $10.00 Median $25.12 Typical High $89.13 | Facility | None | $10.00 | $25.12 | $89.13 |
United Setting Professional Modifier None Typical Low $11.75 Median $15.85 Typical High $22.91 | Professional | None | $11.75 | $15.85 | $22.91 |
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 $12.30 Median $16.22 Typical High $16.22 | Professional | 52 · Reduced service | $12.30 | $16.22 | $16.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.01 Median $6.46 Typical High $6.46 | Professional | 53 · Discontinued | $5.01 | $6.46 | $6.46 |
Where Alabama sits
The same service costs 7.8 times more in Vermont than in Alabama. 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· 51st of 51
$18.62
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.