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 $4.57 Median $4.57 Typical High $6.17 | Facility | None | $4.57 | $4.57 | $6.17 |
Aetna Setting Professional Modifier None Typical Low $2.95 Median $4.57 Typical High $4.57 | Professional | None | $2.95 | $4.57 | $4.57 |
BCBS Alabama Setting Facility Modifier None Typical Low $8.13 Median $8.32 Typical High $8.32 | Facility | None | $8.13 | $8.32 | $8.32 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers Typical Low $2.00 Median $2.40 Typical High $2.57 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $2.00 | $2.40 | $2.57 |
Cigna Setting Facility Modifier None Typical Low $3.24 Median $3.39 Typical High $12.30 | Facility | None | $3.24 | $3.39 | $12.30 |
Cigna Setting Professional Modifier None Typical Low $1.48 Median $2.45 Typical High $13.49 | Professional | None | $1.48 | $2.45 | $13.49 |
United Setting Facility Modifier None Typical Low $1.45 Median $3.63 Typical High $3.98 | Facility | None | $1.45 | $3.63 | $3.98 |
United Setting Professional Modifier None Typical Low $1.95 Median $2.40 Typical High $3.63 | Professional | None | $1.95 | $2.40 | $3.63 |
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 $1.66 Median $2.29 Typical High $2.29 | Professional | 52 · Reduced service | $1.66 | $2.29 | $2.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.66 Median $0.91 Typical High $0.91 | Professional | 53 · Discontinued | $0.66 | $0.91 | $0.91 |
Where Alabama sits
The same service costs 3.3 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· 10th of 51
$4.57
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.