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 $7.24 Median $8.32 Typical High $11.22 | Facility | None | $7.24 | $8.32 | $11.22 |
Aetna Setting Professional Modifier None Typical Low $4.79 Median $8.32 Typical High $8.71 | Professional | None | $4.79 | $8.32 | $8.71 |
Ambetter Setting Professional Modifier None Typical Low $3.63 Median $3.63 Typical High $9.77 | Professional | None | $3.63 | $3.63 | $9.77 |
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 $4.47 Median $5.37 Typical High $6.61 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $4.47 | $5.37 | $6.61 |
Cigna Setting Facility Modifier None Typical Low $5.89 Median $6.03 Typical High $22.39 | Facility | None | $5.89 | $6.03 | $22.39 |
Cigna Setting Professional Modifier None Typical Low $3.63 Median $4.47 Typical High $40.74 | Professional | None | $3.63 | $4.47 | $40.74 |
United Setting Facility Modifier None Typical Low $2.57 Median $6.46 Typical High $7.24 | Facility | None | $2.57 | $6.46 | $7.24 |
United Setting Professional Modifier None Typical Low $3.02 Median $3.63 Typical High $5.25 | Professional | None | $3.02 | $3.63 | $5.25 |
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 $3.24 Median $4.17 Typical High $4.17 | Professional | 52 · Reduced service | $3.24 | $4.17 | $4.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.29 Median $1.66 Typical High $1.66 | Professional | 53 · Discontinued | $1.29 | $1.66 | $1.66 |
Where Alabama sits
The same service costs 5.8 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· 36th 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.