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 $6.03 Median $6.92 Typical High $12.59 | Facility | None | $6.03 | $6.92 | $12.59 |
Aetna Setting Professional Modifier None Typical Low $3.98 Median $6.92 Typical High $7.24 | Professional | None | $3.98 | $6.92 | $7.24 |
Ambetter Setting Professional Modifier None Typical Low $3.02 Median $3.02 Typical High $8.13 | Professional | None | $3.02 | $3.02 | $8.13 |
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 $4.17 Median $5.01 Typical High $6.17 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $4.17 | $5.01 | $6.17 |
Cigna Setting Facility Modifier None Typical Low $4.90 Median $5.13 Typical High $19.50 | Facility | None | $4.90 | $5.13 | $19.50 |
Cigna Setting Professional Modifier None Typical Low $3.09 Median $3.72 Typical High $34.67 | Professional | None | $3.09 | $3.72 | $34.67 |
United Setting Facility Modifier None Typical Low $2.00 Median $5.37 Typical High $15.14 | Facility | None | $2.00 | $5.37 | $15.14 |
United Setting Professional Modifier None Typical Low $2.51 Median $3.16 Typical High $4.90 | Professional | None | $2.51 | $3.16 | $4.90 |
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 $2.69 Median $3.47 Typical High $3.47 | Professional | 52 · Reduced service | $2.69 | $3.47 | $3.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.07 Median $1.38 Typical High $1.38 | Professional | 53 · Discontinued | $1.07 | $1.38 | $1.38 |
Where Alabama sits
The same service costs 14.5 times more in Minnesota 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· 43rd of 51
$5.37
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.