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 $7.59 Median $8.71 Typical High $8.71 | Facility | None | $7.59 | $8.71 | $8.71 |
Aetna Setting Professional Modifier None Typical Low $6.03 Median $8.71 Typical High $8.91 | Professional | None | $6.03 | $8.71 | $8.91 |
Ambetter Setting Professional Modifier None Typical Low $3.80 Median $3.80 Typical High $10.23 | Professional | None | $3.80 | $3.80 | $10.23 |
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 $4.07 Median $4.90 Typical High $5.89 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $4.07 | $4.90 | $5.89 |
Cigna Setting Facility Modifier None Typical Low $6.17 Median $6.31 Typical High $23.44 | Facility | None | $6.17 | $6.31 | $23.44 |
Cigna Setting Professional Modifier None Typical Low $4.47 Median $6.31 Typical High $43.65 | Professional | None | $4.47 | $6.31 | $43.65 |
United Setting Facility Modifier None Typical Low $2.45 Median $2.69 Typical High $7.59 | Facility | None | $2.45 | $2.69 | $7.59 |
United Setting Professional Modifier None Typical Low $3.16 Median $3.80 Typical High $4.79 | Professional | None | $3.16 | $3.80 | $4.79 |
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 $3.39 Median $4.37 Typical High $4.37 | Professional | 52 · Reduced service | $3.39 | $4.37 | $4.37 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.35 Median $1.74 Typical High $1.74 | Professional | 53 · Discontinued | $1.35 | $1.74 | $1.74 |
Where Alabama sits
The same service costs 21.4 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· 38th 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.