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 $5.01 Median $5.75 Typical High $5.75 | Facility | None | $5.01 | $5.75 | $5.75 |
Aetna Setting Professional Modifier None Typical Low $3.80 Median $5.75 Typical High $5.75 | Professional | None | $3.80 | $5.75 | $5.75 |
Ambetter Setting Professional Modifier None Typical Low $2.14 Median $2.51 Typical High $5.01 | Professional | None | $2.14 | $2.51 | $5.01 |
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 $2.63 Median $3.24 Typical High $3.24 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $2.63 | $3.24 | $3.24 |
Cigna Setting Facility Modifier None Typical Low $4.07 Median $4.27 Typical High $16.60 | Facility | None | $4.07 | $4.27 | $16.60 |
Cigna Setting Professional Modifier None Typical Low $1.95 Median $3.24 Typical High $17.78 | Professional | None | $1.95 | $3.24 | $17.78 |
United Setting Facility Modifier None Typical Low $1.82 Median $4.57 Typical High $8.32 | Facility | None | $1.82 | $4.57 | $8.32 |
United Setting Professional Modifier None Typical Low $2.51 Median $3.02 Typical High $4.57 | Professional | None | $2.51 | $3.02 | $4.57 |
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 $2.04 Median $2.88 Typical High $2.88 | Professional | 52 · Reduced service | $2.04 | $2.88 | $2.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.83 Median $1.15 Typical High $1.15 | Professional | 53 · Discontinued | $0.83 | $1.15 | $1.15 |
Where Alabama sits
The same service costs 3.0 times more in Alaska 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· 12th of 51
$5.75
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.