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 $16.98 Median $19.50 Typical High $26.30 | Facility | None | $16.98 | $19.50 | $26.30 |
Aetna Setting Professional Modifier None Typical Low $11.22 Median $19.50 Typical High $20.42 | Professional | None | $11.22 | $19.50 | $20.42 |
Ambetter Setting Professional Modifier None Typical Low $5.13 Median $8.51 Typical High $11.75 | Professional | None | $5.13 | $8.51 | $11.75 |
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 $11.75 Median $14.13 Typical High $17.38 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $11.75 | $14.13 | $17.38 |
Cigna Setting Facility Modifier None Typical Low $13.80 Median $14.45 Typical High $53.70 | Facility | None | $13.80 | $14.45 | $53.70 |
Cigna Setting Professional Modifier None Typical Low $8.71 Median $10.72 Typical High $95.50 | Professional | None | $8.71 | $10.72 | $95.50 |
United Setting Facility Modifier None Typical Low $6.17 Median $15.14 Typical High $16.98 | Facility | None | $6.17 | $15.14 | $16.98 |
United Setting Professional Modifier None Typical Low $7.08 Median $8.51 Typical High $13.80 | Professional | None | $7.08 | $8.51 | $13.80 |
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 $7.59 Median $9.77 Typical High $9.77 | Professional | 52 · Reduced service | $7.59 | $9.77 | $9.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.02 Median $3.89 Typical High $3.89 | Professional | 53 · Discontinued | $3.02 | $3.89 | $3.89 |
Where Alabama sits
The same service costs 8.5 times more in Vermont than in Rhode Island. 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· 25th of 51
$18.20
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.