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 $10.96 Median $10.96 Typical High $14.79 | Facility | None | $10.96 | $10.96 | $14.79 |
Aetna Setting Professional Modifier None Typical Low $6.46 Median $10.96 Typical High $10.96 | Professional | None | $6.46 | $10.96 | $10.96 |
Ambetter Setting Professional Modifier None Typical Low $6.46 Median $6.46 Typical High $6.76 | Professional | None | $6.46 | $6.46 | $6.76 |
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 $6.76 Median $8.13 Typical High $9.77 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $6.76 | $8.13 | $9.77 |
Cigna Setting Facility Modifier None Typical Low $7.76 Median $8.13 Typical High $30.90 | Facility | None | $7.76 | $8.13 | $30.90 |
Cigna Setting Professional Modifier None Typical Low $5.01 Median $6.03 Typical High $54.95 | Professional | None | $5.01 | $6.03 | $54.95 |
United Setting Facility Modifier None Typical Low $3.47 Median $8.71 Typical High $9.55 | Facility | None | $3.47 | $8.71 | $9.55 |
United Setting Professional Modifier None Typical Low $4.07 Median $5.50 Typical High $7.94 | Professional | None | $4.07 | $5.50 | $7.94 |
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 $4.27 Median $5.50 Typical High $5.50 | Professional | 52 · Reduced service | $4.27 | $5.50 | $5.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.70 Median $2.19 Typical High $2.19 | Professional | 53 · Discontinued | $1.70 | $2.19 | $2.19 |
Where Alabama sits
The same service costs 8.3 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
$5.50
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.