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 $9.12 Median $9.12 Typical High $12.30 | Facility | None | $9.12 | $9.12 | $12.30 |
Aetna Setting Professional Modifier None Typical Low $4.17 Median $9.12 Typical High $9.12 | Professional | None | $4.17 | $9.12 | $9.12 |
BCBS Alabama Setting Facility Modifier None Typical Low $15.14 Median $15.14 Typical High $15.14 | Facility | None | $15.14 | $15.14 | $15.14 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers Typical Low $5.01 Median $6.17 Typical High $7.41 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $5.01 | $6.17 | $7.41 |
Cigna Setting Facility Modifier None Typical Low $6.46 Median $6.76 Typical High $25.70 | Facility | None | $6.46 | $6.76 | $25.70 |
Cigna Setting Professional Modifier None Typical Low $4.07 Median $4.90 Typical High $44.67 | Professional | None | $4.07 | $4.90 | $44.67 |
United Setting Facility Modifier None Typical Low $2.88 Median $7.24 Typical High $7.94 | Facility | None | $2.88 | $7.24 | $7.94 |
United Setting Professional Modifier None Typical Low $3.39 Median $4.17 Typical High $5.89 | Professional | None | $3.39 | $4.17 | $5.89 |
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 $3.55 Median $4.57 Typical High $4.57 | Professional | 52 · Reduced service | $3.55 | $4.57 | $4.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.41 Median $1.82 Typical High $1.82 | Professional | 53 · Discontinued | $1.41 | $1.82 | $1.82 |
Where Alabama sits
The same service costs 4.5 times more in Kansas than in New Jersey. 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· 14th of 51
$9.12
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.