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 $17.78 Median $17.78 Typical High $23.99 | Facility | None | $17.78 | $17.78 | $23.99 |
Aetna Setting Professional Modifier None Typical Low $11.75 Median $17.78 Typical High $17.78 | Professional | None | $11.75 | $17.78 | $17.78 |
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 $10.00 Median $12.02 Typical High $14.45 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $10.00 | $12.02 | $14.45 |
Cigna Setting Facility Modifier None Typical Low $12.59 Median $13.18 Typical High $48.98 | Facility | None | $12.59 | $13.18 | $48.98 |
Cigna Setting Professional Modifier None Typical Low $7.24 Median $8.91 Typical High $81.28 | Professional | None | $7.24 | $8.91 | $81.28 |
United Setting Facility Modifier None Typical Low $5.62 Median $13.80 Typical High $15.49 | Facility | None | $5.62 | $13.80 | $15.49 |
United Setting Professional Modifier None Typical Low $6.46 Median $8.13 Typical High $11.75 | Professional | None | $6.46 | $8.13 | $11.75 |
3 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 $6.31 Median $8.91 Typical High $8.91 | Professional | 52 · Reduced service | $6.31 | $8.91 | $8.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.51 Median $3.55 Typical High $3.55 | Professional | 53 · Discontinued | $2.51 | $3.55 | $3.55 |
Ambetter Setting Professional Modifier GY · Excluded by law Typical Low $9.55 Median $9.55 Typical High $9.55 | Professional | GY · Excluded by law | $9.55 | $9.55 | $9.55 |
Where Alabama sits
The same service costs 3.2 times more in Alaska than in New Jersey. 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· 16th of 51
$17.78
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.