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 $21.88 Median $21.88 Typical High $29.51 | Facility | None | $21.88 | $21.88 | $29.51 |
Aetna Setting Professional Modifier None Typical Low $10.00 Median $21.88 Typical High $21.88 | Professional | None | $10.00 | $21.88 | $21.88 |
Ambetter Setting Professional Modifier None Typical Low $12.59 Median $12.59 Typical High $13.18 | Professional | None | $12.59 | $12.59 | $13.18 |
BCBS Alabama Setting Facility Modifier None Typical Low $5.37 Median $5.50 Typical High $5.50 | Facility | None | $5.37 | $5.50 | $5.50 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers Typical Low $13.18 Median $15.85 Typical High $19.50 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $13.18 | $15.85 | $19.50 |
Cigna Setting Facility Modifier None Typical Low $15.49 Median $16.22 Typical High $60.26 | Facility | None | $15.49 | $16.22 | $60.26 |
Cigna Setting Professional Modifier None Typical Low $9.77 Median $11.75 Typical High $107.15 | Professional | None | $9.77 | $11.75 | $107.15 |
United Setting Facility Modifier None Typical Low $6.92 Median $16.98 Typical High $60.26 | Facility | None | $6.92 | $16.98 | $60.26 |
United Setting Professional Modifier None Typical Low $7.94 Median $9.55 Typical High $15.49 | Professional | None | $7.94 | $9.55 | $15.49 |
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 $8.51 Median $10.96 Typical High $10.96 | Professional | 52 · Reduced service | $8.51 | $10.96 | $10.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.39 Median $4.37 Typical High $4.37 | Professional | 53 · Discontinued | $3.39 | $4.37 | $4.37 |
Where Alabama sits
The same service costs 5.5 times more in Kansas than in Alabama. 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· 51st of 51
$7.94
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.