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 $18.20 Median $21.38 Typical High $29.51 | Facility | None | $18.20 | $21.38 | $29.51 |
Aetna Setting Professional Modifier None Typical Low $12.30 Median $21.38 Typical High $22.91 | Professional | None | $12.30 | $21.38 | $22.91 |
Ambetter Setting Professional Modifier None Typical Low $7.76 Median $9.12 Typical High $23.99 | Professional | None | $7.76 | $9.12 | $23.99 |
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 $12.88 Median $15.49 Typical High $18.62 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $12.88 | $15.49 | $18.62 |
Cigna Setting Facility Modifier None Typical Low $14.79 Median $15.49 Typical High $58.88 | Facility | None | $14.79 | $15.49 | $58.88 |
Cigna Setting Professional Modifier None Typical Low $8.13 Median $11.48 Typical High $104.71 | Professional | None | $8.13 | $11.48 | $104.71 |
United Setting Facility Modifier None Typical Low $6.61 Median $16.60 Typical High $18.20 | Facility | None | $6.61 | $16.60 | $18.20 |
United Setting Professional Modifier None Typical Low $7.76 Median $10.47 Typical High $15.14 | Professional | None | $7.76 | $10.47 | $15.14 |
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 $8.13 Median $10.47 Typical High $10.47 | Professional | 52 · Reduced service | $8.13 | $10.47 | $10.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.24 Median $4.27 Typical High $4.27 | Professional | 53 · Discontinued | $3.24 | $4.27 | $4.27 |
Where Alabama sits
The same service costs 7.1 times more in Vermont than in Illinois. 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· 35th 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.