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 $6.61 Median $6.61 Typical High $8.91 | Facility | None | $6.61 | $6.61 | $8.91 |
Aetna Setting Professional Modifier None Typical Low $4.68 Median $6.61 Typical High $6.61 | Professional | None | $4.68 | $6.61 | $6.61 |
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 $3.98 Median $4.79 Typical High $5.89 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $3.98 | $4.79 | $5.89 |
Cigna Setting Facility Modifier None Typical Low $4.68 Median $4.90 Typical High $18.62 | Facility | None | $4.68 | $4.90 | $18.62 |
Cigna Setting Professional Modifier None Typical Low $2.95 Median $3.55 Typical High $33.11 | Professional | None | $2.95 | $3.55 | $33.11 |
United Setting Facility Modifier None Typical Low $2.09 Median $5.25 Typical High $5.75 | Facility | None | $2.09 | $5.25 | $5.75 |
United Setting Professional Modifier None Typical Low $2.40 Median $3.31 Typical High $4.68 | Professional | None | $2.40 | $3.31 | $4.68 |
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 $2.57 Median $3.31 Typical High $3.31 | Professional | 52 · Reduced service | $2.57 | $3.31 | $3.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.02 Median $1.32 Typical High $1.32 | Professional | 53 · Discontinued | $1.02 | $1.32 | $1.32 |
Where Alabama sits
The same service costs 4.0 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· 12th of 51
$6.92
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.