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 $3.98 Median $3.98 Typical High $5.25 | Facility | None | $3.98 | $3.98 | $5.25 |
Aetna Setting Professional Modifier None Typical Low $2.82 Median $3.98 Typical High $3.98 | Professional | None | $2.82 | $3.98 | $3.98 |
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 $2.24 Median $2.45 Typical High $2.95 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $2.24 | $2.45 | $2.95 |
Cigna Setting Facility Modifier None Typical Low $2.82 Median $2.88 Typical High $11.22 | Facility | None | $2.82 | $2.88 | $11.22 |
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 $1.23 Median $3.09 Typical High $3.47 | Facility | None | $1.23 | $3.09 | $3.47 |
United Setting Professional Modifier None Typical Low $1.45 Median $1.74 Typical High $2.34 | Professional | None | $1.45 | $1.74 | $2.34 |
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 $1.51 Median $1.95 Typical High $1.95 | Professional | 52 · Reduced service | $1.51 | $1.95 | $1.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.62 Median $0.79 Typical High $0.79 | Professional | 53 · Discontinued | $0.62 | $0.79 | $0.79 |
Where Alabama sits
The same service costs 6.2 times more in Kansas 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· 19th of 51
$3.98
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.