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 $4.27 Median $4.90 Typical High $6.61 | Facility | None | $4.27 | $4.90 | $6.61 |
Aetna Setting Professional Modifier None Typical Low $3.80 Median $4.90 Typical High $5.01 | Professional | None | $3.80 | $4.90 | $5.01 |
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 $2.95 Median $3.55 Typical High $4.37 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $2.95 | $3.55 | $4.37 |
Cigna Setting Facility Modifier None Typical Low $3.47 Median $3.63 Typical High $13.49 | Facility | None | $3.47 | $3.63 | $13.49 |
Cigna Setting Professional Modifier None Typical Low $2.14 Median $2.63 Typical High $23.99 | Professional | None | $2.14 | $2.63 | $23.99 |
United Setting Facility Modifier None Typical Low $1.55 Median $3.89 Typical High $10.47 | Facility | None | $1.55 | $3.89 | $10.47 |
United Setting Professional Modifier None Typical Low $1.82 Median $2.45 Typical High $3.47 | Professional | None | $1.82 | $2.45 | $3.47 |
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 $1.91 Median $2.45 Typical High $2.45 | Professional | 52 · Reduced service | $1.91 | $2.45 | $2.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.76 Median $0.98 Typical High $0.98 | Professional | 53 · Discontinued | $0.76 | $0.98 | $0.98 |
Where Alabama sits
The same service costs 3.6 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· 13th of 51
$5.37
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.