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 $25.70 Median $29.51 Typical High $48.98 | Facility | None | $25.70 | $29.51 | $48.98 |
Aetna Setting Professional Modifier None Typical Low $16.98 Median $29.51 Typical High $30.90 | Professional | None | $16.98 | $29.51 | $30.90 |
Ambetter Setting Professional Modifier None Typical Low $10.96 Median $12.88 Typical High $17.78 | Professional | None | $10.96 | $12.88 | $17.78 |
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 $17.78 Median $21.88 Typical High $26.30 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $17.78 | $21.88 | $26.30 |
Cigna Setting Facility Modifier None Typical Low $20.89 Median $21.88 Typical High $83.18 | Facility | None | $20.89 | $21.88 | $83.18 |
Cigna Setting Professional Modifier None Typical Low $13.18 Median $15.85 Typical High $147.91 | Professional | None | $13.18 | $15.85 | $147.91 |
United Setting Facility Modifier None Typical Low $9.33 Median $23.44 Typical High $104.71 | Facility | None | $9.33 | $23.44 | $104.71 |
United Setting Professional Modifier None Typical Low $10.96 Median $12.88 Typical High $20.89 | Professional | None | $10.96 | $12.88 | $20.89 |
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 $11.48 Median $14.79 Typical High $14.79 | Professional | 52 · Reduced service | $11.48 | $14.79 | $14.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.57 Median $5.89 Typical High $5.89 | Professional | 53 · Discontinued | $4.57 | $5.89 | $5.89 |
Where Alabama sits
The same service costs 7.4 times more in Vermont 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.