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 $6.31 Median $6.31 Typical High $8.51 | Facility | None | $6.31 | $6.31 | $8.51 |
Aetna Setting Professional Modifier None Typical Low $2.88 Median $6.31 Typical High $6.31 | Professional | None | $2.88 | $6.31 | $6.31 |
Ambetter Setting Professional Modifier None Typical Low $2.75 Median $2.75 Typical High $7.41 | Professional | None | $2.75 | $2.75 | $7.41 |
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 $3.80 Median $4.68 Typical High $5.62 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $3.80 | $4.68 | $5.62 |
Cigna Setting Facility Modifier None Typical Low $4.47 Median $4.68 Typical High $17.38 | Facility | None | $4.47 | $4.68 | $17.38 |
Cigna Setting Professional Modifier None Typical Low $2.82 Median $3.39 Typical High $31.62 | Professional | None | $2.82 | $3.39 | $31.62 |
United Setting Facility Modifier None Typical Low $2.00 Median $5.01 Typical High $12.02 | Facility | None | $2.00 | $5.01 | $12.02 |
United Setting Professional Modifier None Typical Low $2.29 Median $3.16 Typical High $4.47 | Professional | None | $2.29 | $3.16 | $4.47 |
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 $2.45 Median $3.16 Typical High $3.16 | Professional | 52 · Reduced service | $2.45 | $3.16 | $3.16 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.98 Median $1.26 Typical High $1.26 | Professional | 53 · Discontinued | $0.98 | $1.26 | $1.26 |
Where Alabama sits
The same service costs 12.3 times more in Vermont 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· 16th of 51
$6.31
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.