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 $11.22 Median $11.22 Typical High $15.14 | Facility | None | $11.22 | $11.22 | $15.14 |
Aetna Setting Professional Modifier None Typical Low $7.94 Median $11.22 Typical High $11.22 | Professional | None | $7.94 | $11.22 | $11.22 |
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 $6.31 Median $7.41 Typical High $8.91 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $6.31 | $7.41 | $8.91 |
Cigna Setting Facility Modifier None Typical Low $7.94 Median $8.32 Typical High $30.90 | Facility | None | $7.94 | $8.32 | $30.90 |
Cigna Setting Professional Modifier None Typical Low $5.25 Median $7.08 Typical High $48.98 | Professional | None | $5.25 | $7.08 | $48.98 |
United Setting Facility Modifier None Typical Low $3.55 Median $8.71 Typical High $9.77 | Facility | None | $3.55 | $8.71 | $9.77 |
United Setting Professional Modifier None Typical Low $4.07 Median $5.01 Typical High $7.08 | Professional | None | $4.07 | $5.01 | $7.08 |
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 $3.98 Median $5.62 Typical High $5.62 | Professional | 52 · Reduced service | $3.98 | $5.62 | $5.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.58 Median $2.24 Typical High $2.24 | Professional | 53 · Discontinued | $1.58 | $2.24 | $2.24 |
Where Alabama sits
The same service costs 4.1 times more in Kansas 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· 5th of 51
$15.14
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.