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 $13.18 Median $13.80 Typical High $18.62 | Facility | None | $13.18 | $13.80 | $18.62 |
Aetna Setting Professional Modifier None Typical Low $9.77 Median $13.80 Typical High $13.80 | Professional | None | $9.77 | $13.80 | $13.80 |
Ambetter Setting Professional Modifier None Typical Low $8.32 Median $8.32 Typical High $8.32 | Professional | None | $8.32 | $8.32 | $8.32 |
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 $8.32 Median $10.00 Typical High $12.30 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $8.32 | $10.00 | $12.30 |
Cigna Setting Facility Modifier None Typical Low $9.77 Median $10.23 Typical High $38.02 | Facility | None | $9.77 | $10.23 | $38.02 |
Cigna Setting Professional Modifier None Typical Low $6.17 Median $7.59 Typical High $69.18 | Professional | None | $6.17 | $7.59 | $69.18 |
United Setting Facility Modifier None Typical Low $4.37 Median $10.72 Typical High $12.02 | Facility | None | $4.37 | $10.72 | $12.02 |
United Setting Professional Modifier None Typical Low $5.01 Median $6.03 Typical High $9.77 | Professional | None | $5.01 | $6.03 | $9.77 |
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 $5.37 Median $6.92 Typical High $6.92 | Professional | 52 · Reduced service | $5.37 | $6.92 | $6.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.14 Median $2.75 Typical High $2.75 | Professional | 53 · Discontinued | $2.14 | $2.75 | $2.75 |
Where Alabama sits
The same service costs 3.9 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· 16th of 51
$13.80
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.