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 $4.37 Median $4.37 Typical High $7.94 | Facility | None | $4.37 | $4.37 | $7.94 |
Aetna Setting Professional Modifier None Typical Low $2.51 Median $4.37 Typical High $4.37 | Professional | None | $2.51 | $4.37 | $4.37 |
Ambetter Setting Professional Modifier None Typical Low $1.91 Median $1.91 Typical High $1.91 | Professional | None | $1.91 | $1.91 | $1.91 |
BCBS Alabama Setting Facility Modifier None Typical Low $8.13 Median $8.32 Typical High $8.32 | Facility | None | $8.13 | $8.32 | $8.32 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers Typical Low $2.40 Median $2.88 Typical High $3.55 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $2.40 | $2.88 | $3.55 |
Cigna Setting Facility Modifier None Typical Low $3.09 Median $3.24 Typical High $12.30 | Facility | None | $3.09 | $3.24 | $12.30 |
Cigna Setting Professional Modifier None Typical Low $1.74 Median $2.14 Typical High $19.50 | Professional | None | $1.74 | $2.14 | $19.50 |
United Setting Facility Modifier None Typical Low $1.38 Median $3.39 Typical High $7.59 | Facility | None | $1.38 | $3.39 | $7.59 |
United Setting Professional Modifier None Typical Low $1.58 Median $1.95 Typical High $2.82 | Professional | None | $1.58 | $1.95 | $2.82 |
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 $1.55 Median $2.19 Typical High $2.19 | Professional | 52 · Reduced service | $1.55 | $2.19 | $2.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.62 Median $0.87 Typical High $0.87 | Professional | 53 · Discontinued | $0.62 | $0.87 | $0.87 |
Where Alabama sits
The same service costs 11.7 times more in Minnesota than in Kentucky. 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· 19th of 51
$4.37
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.