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 $11.48 Median $13.18 Typical High $15.49 | Facility | None | $11.48 | $13.18 | $15.49 |
Aetna Setting Professional Modifier None Typical Low $6.92 Median $13.18 Typical High $13.18 | Professional | None | $6.92 | $13.18 | $13.18 |
Ambetter Setting Professional Modifier None Typical Low $5.75 Median $5.75 Typical High $7.24 | Professional | None | $5.75 | $5.75 | $7.24 |
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 $7.59 Median $9.12 Typical High $11.22 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $7.59 | $9.12 | $11.22 |
Cigna Setting Facility Modifier None Typical Low $9.33 Median $9.77 Typical High $37.15 | Facility | None | $9.33 | $9.77 | $37.15 |
Cigna Setting Professional Modifier None Typical Low $5.01 Median $6.46 Typical High $16.60 | Professional | None | $5.01 | $6.46 | $16.60 |
United Setting Facility Modifier None Typical Low $4.17 Median $10.47 Typical High $11.48 | Facility | None | $4.17 | $10.47 | $11.48 |
United Setting Professional Modifier None Typical Low $4.79 Median $5.75 Typical High $6.92 | Professional | None | $4.79 | $5.75 | $6.92 |
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 $4.68 Median $6.61 Typical High $6.61 | Professional | 52 · Reduced service | $4.68 | $6.61 | $6.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.91 Median $2.63 Typical High $2.63 | Professional | 53 · Discontinued | $1.91 | $2.63 | $2.63 |
Where Alabama sits
The same service costs 24.0 times more in Vermont 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
$13.18
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.