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 $10.23 Median $10.23 Typical High $13.49 | Facility | None | $10.23 | $10.23 | $13.49 |
Aetna Setting Professional Modifier None Typical Low $7.94 Median $10.23 Typical High $10.23 | Professional | None | $7.94 | $10.23 | $10.23 |
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 $5.75 Median $7.41 Typical High $9.12 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $5.75 | $7.41 | $9.12 |
Cigna Setting Facility Modifier None Typical Low $7.24 Median $7.41 Typical High $27.54 | Facility | None | $7.24 | $7.41 | $27.54 |
Cigna Setting Professional Modifier None Typical Low $4.57 Median $5.50 Typical High $51.29 | Professional | None | $4.57 | $5.50 | $51.29 |
United Setting Facility Modifier None Typical Low $3.16 Median $7.94 Typical High $30.20 | Facility | None | $3.16 | $7.94 | $30.20 |
United Setting Professional Modifier None Typical Low $3.72 Median $5.01 Typical High $7.24 | Professional | None | $3.72 | $5.01 | $7.24 |
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 $5.13 Typical High $5.13 | Professional | 52 · Reduced service | $3.98 | $5.13 | $5.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.58 Median $2.04 Typical High $2.04 | Professional | 53 · Discontinued | $1.58 | $2.04 | $2.04 |
Where Alabama sits
The same service costs 3.8 times more in Kansas than in Oklahoma. 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
$14.79
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.