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 $29.51 Median $30.90 Typical High $41.69 | Facility | None | $29.51 | $30.90 | $41.69 |
Aetna Setting Professional Modifier None Typical Low $14.13 Median $30.90 Typical High $30.90 | Professional | None | $14.13 | $30.90 | $30.90 |
Ambetter Setting Professional Modifier None Typical Low $16.22 Median $17.78 Typical High $36.31 | Professional | None | $16.22 | $17.78 | $36.31 |
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 $18.62 Median $22.39 Typical High $27.54 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $18.62 | $22.39 | $27.54 |
Cigna Setting Facility Modifier None Typical Low $21.88 Median $22.39 Typical High $85.11 | Facility | None | $21.88 | $22.39 | $85.11 |
Cigna Setting Professional Modifier None Typical Low $13.80 Median $16.60 Typical High $151.36 | Professional | None | $13.80 | $16.60 | $151.36 |
United Setting Facility Modifier None Typical Low $9.55 Median $23.99 Typical High $26.92 | Facility | None | $9.55 | $23.99 | $26.92 |
United Setting Professional Modifier None Typical Low $11.22 Median $15.49 Typical High $21.88 | Professional | None | $11.22 | $15.49 | $21.88 |
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 $12.02 Median $15.49 Typical High $15.49 | Professional | 52 · Reduced service | $12.02 | $15.49 | $15.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.79 Median $6.17 Typical High $6.17 | Professional | 53 · Discontinued | $4.79 | $6.17 | $6.17 |
Where Alabama sits
The same service costs 4.5 times more in South Carolina than in Alabama. 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· 51st 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.