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 $28.18 Median $29.51 Typical High $29.51 | Facility | None | $28.18 | $29.51 | $29.51 |
Aetna Setting Professional Modifier None Typical Low $13.18 Median $29.51 Typical High $29.51 | Professional | None | $13.18 | $29.51 | $29.51 |
Ambetter Setting Professional Modifier None Typical Low $13.80 Median $15.85 Typical High $34.67 | Professional | None | $13.80 | $15.85 | $34.67 |
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 $17.78 Median $21.38 Typical High $25.70 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $17.78 | $21.38 | $25.70 |
Cigna Setting Facility Modifier None Typical Low $20.89 Median $21.38 Typical High $81.28 | Facility | None | $20.89 | $21.38 | $81.28 |
Cigna Setting Professional Modifier None Typical Low $10.96 Median $14.13 Typical High $36.31 | Professional | None | $10.96 | $14.13 | $36.31 |
United Setting Facility Modifier None Typical Low $9.12 Median $22.91 Typical High $25.70 | Facility | None | $9.12 | $22.91 | $25.70 |
United Setting Professional Modifier None Typical Low $10.72 Median $12.59 Typical High $15.14 | Professional | None | $10.72 | $12.59 | $15.14 |
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 $10.47 Median $14.79 Typical High $14.79 | Professional | 52 · Reduced service | $10.47 | $14.79 | $14.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.17 Median $5.89 Typical High $5.89 | Professional | 53 · Discontinued | $4.17 | $5.89 | $5.89 |
Where Alabama sits
The same service costs 3.8 times more in Alaska 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.