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 $9.33 Median $9.33 Typical High $12.59 | Facility | None | $9.33 | $9.33 | $12.59 |
Aetna Setting Professional Modifier None Typical Low $4.07 Median $9.33 Typical High $9.33 | Professional | None | $4.07 | $9.33 | $9.33 |
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 $4.90 Median $5.89 Typical High $7.08 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $4.90 | $5.89 | $7.08 |
Cigna Setting Facility Modifier None Typical Low $6.61 Median $6.92 Typical High $25.70 | Facility | None | $6.61 | $6.92 | $25.70 |
Cigna Setting Professional Modifier None Typical Low $3.63 Median $4.27 Typical High $40.74 | Professional | None | $3.63 | $4.27 | $40.74 |
United Setting Facility Modifier None Typical Low $2.95 Median $7.24 Typical High $8.13 | Facility | None | $2.95 | $7.24 | $8.13 |
United Setting Professional Modifier None Typical Low $3.39 Median $4.07 Typical High $5.75 | Professional | None | $3.39 | $4.07 | $5.75 |
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 $3.31 Median $4.68 Typical High $4.68 | Professional | 52 · Reduced service | $3.31 | $4.68 | $4.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.32 Median $1.86 Typical High $1.86 | Professional | 53 · Discontinued | $1.32 | $1.86 | $1.86 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $3.47 Median $4.07 Typical High $4.07 | Professional | 59 · Distinct service | $3.47 | $4.07 | $4.07 |
Where Alabama sits
The same service costs 8.3 times more in Kansas 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· 31st 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.