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 $7.76 Median $7.76 Typical High $10.47 | Facility | None | $7.76 | $7.76 | $10.47 |
Aetna Setting Professional Modifier None Typical Low $6.03 Median $7.76 Typical High $7.76 | Professional | None | $6.03 | $7.76 | $7.76 |
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 $4.79 Median $5.75 Typical High $6.92 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $4.79 | $5.75 | $6.92 |
Cigna Setting Facility Modifier None Typical Low $5.50 Median $5.75 Typical High $21.38 | Facility | None | $5.50 | $5.75 | $21.38 |
Cigna Setting Professional Modifier None Typical Low $3.47 Median $4.27 Typical High $38.90 | Professional | None | $3.47 | $4.27 | $38.90 |
United Setting Facility Modifier None Typical Low $2.45 Median $6.17 Typical High $19.50 | Facility | None | $2.45 | $6.17 | $19.50 |
United Setting Professional Modifier None Typical Low $2.88 Median $3.39 Typical High $5.62 | Professional | None | $2.88 | $3.39 | $5.62 |
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 $3.02 Median $3.89 Typical High $3.89 | Professional | 52 · Reduced service | $3.02 | $3.89 | $3.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.20 Median $1.58 Typical High $1.58 | Professional | 53 · Discontinued | $1.20 | $1.58 | $1.58 |
Where Alabama sits
The same service costs 3.3 times more in Kansas than in Delaware. 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· 15th of 51
$8.13
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.