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 $4.47 Median $5.25 Typical High $7.24 | Facility | None | $4.47 | $5.25 | $7.24 |
Aetna Setting Professional Modifier None Typical Low $3.02 Median $5.25 Typical High $5.37 | Professional | None | $3.02 | $5.25 | $5.37 |
Ambetter Setting Professional Modifier None Typical Low $1.91 Median $2.24 Typical High $5.25 | Professional | None | $1.91 | $2.24 | $5.25 |
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 $3.16 Median $3.80 Typical High $4.57 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $3.16 | $3.80 | $4.57 |
Cigna Setting Facility Modifier None Typical Low $3.72 Median $3.80 Typical High $14.45 | Facility | None | $3.72 | $3.80 | $14.45 |
Cigna Setting Professional Modifier None Typical Low $2.29 Median $2.75 Typical High $25.70 | Professional | None | $2.29 | $2.75 | $25.70 |
United Setting Facility Modifier None Typical Low $1.62 Median $4.07 Typical High $10.47 | Facility | None | $1.62 | $4.07 | $10.47 |
United Setting Professional Modifier None Typical Low $1.91 Median $2.24 Typical High $3.72 | Professional | None | $1.91 | $2.24 | $3.72 |
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 $2.00 Median $2.57 Typical High $2.57 | Professional | 52 · Reduced service | $2.00 | $2.57 | $2.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.79 Median $1.05 Typical High $1.05 | Professional | 53 · Discontinued | $0.79 | $1.05 | $1.05 |
Where Alabama sits
The same service costs 15.8 times more in Vermont than in Maryland. 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· 21st of 51
$5.25
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.