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 $6.46 Median $6.46 Typical High $8.71 | Facility | None | $6.46 | $6.46 | $8.71 |
Aetna Setting Professional Modifier None Typical Low $4.57 Median $6.46 Typical High $6.46 | Professional | None | $4.57 | $6.46 | $6.46 |
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 $3.63 Median $4.37 Typical High $5.25 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $3.63 | $4.37 | $5.25 |
Cigna Setting Facility Modifier None Typical Low $4.57 Median $4.79 Typical High $17.38 | Facility | None | $4.57 | $4.79 | $17.38 |
Cigna Setting Professional Modifier None Typical Low $2.69 Median $3.24 Typical High $30.20 | Professional | None | $2.69 | $3.24 | $30.20 |
United Setting Facility Modifier None Typical Low $2.04 Median $5.01 Typical High $10.47 | Facility | None | $2.04 | $5.01 | $10.47 |
United Setting Professional Modifier None Typical Low $2.34 Median $2.95 Typical High $4.27 | Professional | None | $2.34 | $2.95 | $4.27 |
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 $2.29 Median $3.24 Typical High $3.24 | Professional | 52 · Reduced service | $2.29 | $3.24 | $3.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.91 Median $1.29 Typical High $1.29 | Professional | 53 · Discontinued | $0.91 | $1.29 | $1.29 |
Ambetter Setting Professional Modifier 90 · Outside lab Typical Low $2.82 Median $2.82 Typical High $2.82 | Professional | 90 · Outside lab | $2.82 | $2.82 | $2.82 |
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· 11th of 51
$7.08
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.