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 $8.51 Median $8.51 Typical High $11.48 | Facility | None | $8.51 | $8.51 | $11.48 |
Aetna Setting Professional Modifier None Typical Low $6.03 Median $8.51 Typical High $8.51 | Professional | None | $6.03 | $8.51 | $8.51 |
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 $4.68 Median $5.62 Typical High $6.76 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $4.68 | $5.62 | $6.76 |
Cigna Setting Facility Modifier None Typical Low $6.03 Median $6.31 Typical High $23.44 | Facility | None | $6.03 | $6.31 | $23.44 |
Cigna Setting Professional Modifier None Typical Low $3.39 Median $4.17 Typical High $37.15 | Professional | None | $3.39 | $4.17 | $37.15 |
United Setting Facility Modifier None Typical Low $2.69 Median $6.76 Typical High $15.14 | Facility | None | $2.69 | $6.76 | $15.14 |
United Setting Professional Modifier None Typical Low $3.16 Median $3.80 Typical High $5.50 | Professional | None | $3.16 | $3.80 | $5.50 |
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 $3.09 Median $4.27 Typical High $4.27 | Professional | 52 · Reduced service | $3.09 | $4.27 | $4.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.23 Median $1.74 Typical High $1.74 | Professional | 53 · Discontinued | $1.23 | $1.74 | $1.74 |
Where Alabama sits
The same service costs 3.5 times more in Kansas than in New Jersey. 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· 21st 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.