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 $16.98 Median $17.78 Typical High $23.99 | Facility | None | $16.98 | $17.78 | $23.99 |
Aetna Setting Professional Modifier None Typical Low $12.59 Median $17.78 Typical High $17.78 | Professional | None | $12.59 | $17.78 | $17.78 |
Ambetter Setting Professional Modifier None Typical Low $10.47 Median $10.72 Typical High $21.38 | Professional | None | $10.47 | $10.72 | $21.38 |
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 $10.72 Median $13.18 Typical High $15.85 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $10.72 | $13.18 | $15.85 |
Cigna Setting Facility Modifier None Typical Low $12.59 Median $13.18 Typical High $48.98 | Facility | None | $12.59 | $13.18 | $48.98 |
Cigna Setting Professional Modifier None Typical Low $7.94 Median $9.77 Typical High $89.13 | Professional | None | $7.94 | $9.77 | $89.13 |
United Setting Facility Modifier None Typical Low $5.62 Median $14.13 Typical High $15.49 | Facility | None | $5.62 | $14.13 | $15.49 |
United Setting Professional Modifier None Typical Low $6.61 Median $8.91 Typical High $12.88 | Professional | None | $6.61 | $8.91 | $12.88 |
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 $6.92 Median $8.91 Typical High $8.91 | Professional | 52 · Reduced service | $6.92 | $8.91 | $8.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.75 Median $3.63 Typical High $3.63 | Professional | 53 · Discontinued | $2.75 | $3.63 | $3.63 |
Where Alabama sits
The same service costs 4.2 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· 27th of 51
$15.14
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.