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 $4.57 Median $4.57 Typical High $6.03 | Facility | None | $4.57 | $4.57 | $6.03 |
Aetna Setting Professional Modifier None Typical Low $3.16 Median $4.57 Typical High $4.57 | Professional | None | $3.16 | $4.57 | $4.57 |
Ambetter Setting Professional Modifier None Typical Low $2.75 Median $2.75 Typical High $2.75 | Professional | None | $2.75 | $2.75 | $2.75 |
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 $2.75 Median $3.31 Typical High $3.98 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $2.75 | $3.31 | $3.98 |
Cigna Setting Facility Modifier None Typical Low $3.24 Median $3.31 Typical High $12.30 | Facility | None | $3.24 | $3.31 | $12.30 |
Cigna Setting Professional Modifier None Typical Low $2.04 Median $2.45 Typical High $22.39 | Professional | None | $2.04 | $2.45 | $22.39 |
United Setting Facility Modifier None Typical Low $1.41 Median $3.55 Typical High $3.98 | Facility | None | $1.41 | $3.55 | $3.98 |
United Setting Professional Modifier None Typical Low $1.66 Median $2.09 Typical High $3.24 | Professional | None | $1.66 | $2.09 | $3.24 |
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 $1.78 Median $2.29 Typical High $2.29 | Professional | 52 · Reduced service | $1.78 | $2.29 | $2.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.71 Median $0.91 Typical High $0.91 | Professional | 53 · Discontinued | $0.71 | $0.91 | $0.91 |
Where Alabama sits
The same service costs 3.4 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· 19th of 51
$4.57
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.