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 $7.94 Median $9.12 Typical High $12.30 | Facility | None | $7.94 | $9.12 | $12.30 |
Aetna Setting Professional Modifier None Typical Low $4.27 Median $9.12 Typical High $9.12 | Professional | None | $4.27 | $9.12 | $9.12 |
Ambetter Setting Professional Modifier None Typical Low $4.79 Median $5.37 Typical High $10.72 | Professional | None | $4.79 | $5.37 | $10.72 |
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 $2.95 Median $3.55 Typical High $4.37 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $2.95 | $3.55 | $4.37 |
Cigna Setting Facility Modifier None Typical Low $6.46 Median $6.76 Typical High $25.70 | Facility | None | $6.46 | $6.76 | $25.70 |
Cigna Setting Professional Modifier None Typical Low $4.17 Median $4.90 Typical High $44.67 | Professional | None | $4.17 | $4.90 | $44.67 |
United Setting Facility Modifier None Typical Low $2.88 Median $7.24 Typical High $7.94 | Facility | None | $2.88 | $7.24 | $7.94 |
United Setting Professional Modifier None Typical Low $3.24 Median $3.39 Typical High $6.61 | Professional | None | $3.24 | $3.39 | $6.61 |
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 $3.55 Median $4.57 Typical High $4.57 | Professional | 52 · Reduced service | $3.55 | $4.57 | $4.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.45 Median $1.82 Typical High $1.82 | Professional | 53 · Discontinued | $1.45 | $1.82 | $1.82 |
Where Alabama sits
The same service costs 3.6 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· 35th 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.