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 $3.63 Median $4.17 Typical High $4.27 | Facility | None | $3.63 | $4.17 | $4.27 |
Aetna Setting Professional Modifier None Typical Low $2.45 Median $4.27 Typical High $4.27 | Professional | None | $2.45 | $4.27 | $4.27 |
Ambetter Setting Professional Modifier None Typical Low $2.19 Median $2.45 Typical High $2.51 | Professional | None | $2.19 | $2.45 | $2.51 |
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 $2.51 Median $3.09 Typical High $3.72 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $2.51 | $3.09 | $3.72 |
Cigna Setting Facility Modifier None Typical Low $3.02 Median $3.09 Typical High $11.22 | Facility | None | $3.02 | $3.09 | $11.22 |
Cigna Setting Professional Modifier None Typical Low $1.86 Median $2.29 Typical High $20.89 | Professional | None | $1.86 | $2.29 | $20.89 |
United Setting Facility Modifier None Typical Low $1.32 Median $3.31 Typical High $10.47 | Facility | None | $1.32 | $3.31 | $10.47 |
United Setting Professional Modifier None Typical Low $1.55 Median $2.09 Typical High $3.02 | Professional | None | $1.55 | $2.09 | $3.02 |
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 $1.62 Median $2.09 Typical High $2.09 | Professional | 52 · Reduced service | $1.62 | $2.09 | $2.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.65 Median $0.83 Typical High $0.83 | Professional | 53 · Discontinued | $0.65 | $0.83 | $0.83 |
Where Alabama sits
The same service costs 10.2 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· 22nd of 51
$4.27
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.