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 $35.48 Median $35.48 Typical High $47.86 | Facility | None | $35.48 | $35.48 | $47.86 |
Aetna Setting Professional Modifier None Typical Low $16.60 Median $35.48 Typical High $35.48 | Professional | None | $16.60 | $35.48 | $35.48 |
Ambetter Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $21.38 | Professional | None | $20.89 | $20.89 | $21.38 |
BCBS Alabama Setting Facility Modifier None Typical Low $18.20 Median $18.62 Typical High $18.62 | Facility | None | $18.20 | $18.62 | $18.62 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers Typical Low $6.46 Median $7.76 Typical High $9.55 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $6.46 | $7.76 | $9.55 |
Cigna Setting Facility Modifier None Typical Low $25.12 Median $26.30 Typical High $97.72 | Facility | None | $25.12 | $26.30 | $97.72 |
Cigna Setting Professional Modifier None Typical Low $15.85 Median $19.05 Typical High $177.83 | Professional | None | $15.85 | $19.05 | $177.83 |
United Setting Facility Modifier None Typical Low $11.22 Median $28.18 Typical High $104.71 | Facility | None | $11.22 | $28.18 | $104.71 |
United Setting Professional Modifier None Typical Low $7.08 Median $12.88 Typical High $19.05 | Professional | None | $7.08 | $12.88 | $19.05 |
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 $13.80 Median $17.78 Typical High $17.78 | Professional | 52 · Reduced service | $13.80 | $17.78 | $17.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.50 Median $7.08 Typical High $7.08 | Professional | 53 · Discontinued | $5.50 | $7.08 | $7.08 |
Where Alabama sits
The same service costs 4.2 times more in Kansas than in Alabama. 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· 51st of 51
$18.62
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.