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 $19.95 Median $20.89 Typical High $27.54 | Facility | None | $19.95 | $20.89 | $27.54 |
Aetna Setting Professional Modifier None Typical Low $14.45 Median $20.89 Typical High $20.89 | Professional | None | $14.45 | $20.89 | $20.89 |
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 $8.32 Median $10.00 Typical High $12.30 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $8.32 | $10.00 | $12.30 |
Cigna Setting Facility Modifier None Typical Low $14.45 Median $15.14 Typical High $57.54 | Facility | None | $14.45 | $15.14 | $57.54 |
Cigna Setting Professional Modifier None Typical Low $9.12 Median $11.22 Typical High $102.33 | Professional | None | $9.12 | $11.22 | $102.33 |
United Setting Facility Modifier None Typical Low $6.46 Median $16.22 Typical High $17.78 | Facility | None | $6.46 | $16.22 | $17.78 |
United Setting Professional Modifier None Typical Low $7.59 Median $8.91 Typical High $10.72 | Professional | None | $7.59 | $8.91 | $10.72 |
3 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 $7.94 Median $10.23 Typical High $10.23 | Professional | 52 · Reduced service | $7.94 | $10.23 | $10.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.24 Median $4.17 Typical High $4.17 | Professional | 53 · Discontinued | $3.24 | $4.17 | $4.17 |
Ambetter Setting Professional Modifier 90 · Outside lab Typical Low $10.72 Median $12.02 Typical High $12.59 | Professional | 90 · Outside lab | $10.72 | $12.02 | $12.59 |
Where Alabama sits
The same service costs 6.2 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
$7.59
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.