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 $18.62 Median $19.50 Typical High $26.30 | Facility | None | $18.62 | $19.50 | $26.30 |
Aetna Setting Professional Modifier None Typical Low $8.91 Median $19.50 Typical High $19.50 | Professional | None | $8.91 | $19.50 | $19.50 |
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 $11.75 Median $14.13 Typical High $17.38 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $11.75 | $14.13 | $17.38 |
Cigna Setting Facility Modifier None Typical Low $13.80 Median $14.45 Typical High $53.70 | Facility | None | $13.80 | $14.45 | $53.70 |
Cigna Setting Professional Modifier None Typical Low $8.71 Median $10.47 Typical High $95.50 | Professional | None | $8.71 | $10.47 | $95.50 |
United Setting Facility Modifier None Typical Low $6.03 Median $15.14 Typical High $16.98 | Facility | None | $6.03 | $15.14 | $16.98 |
United Setting Professional Modifier None Typical Low $7.08 Median $9.77 Typical High $13.80 | Professional | None | $7.08 | $9.77 | $13.80 |
3 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 $7.59 Median $9.77 Typical High $9.77 | Professional | 52 · Reduced service | $7.59 | $9.77 | $9.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.02 Median $3.89 Typical High $3.89 | Professional | 53 · Discontinued | $3.02 | $3.89 | $3.89 |
Ambetter Setting Professional Modifier 90 · Outside lab Typical Low $11.75 Median $11.75 Typical High $11.75 | Professional | 90 · Outside lab | $11.75 | $11.75 | $11.75 |
Where Alabama sits
The same service costs 3.2 times more in Alaska than in Nebraska. 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· 33rd 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.