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 $5.62 Median $6.46 Typical High $9.12 | Facility | None | $5.62 | $6.46 | $9.12 |
Aetna Setting Professional Modifier None Typical Low $4.57 Median $6.46 Typical High $6.76 | Professional | None | $4.57 | $6.46 | $6.76 |
Ambetter Setting Professional Modifier None Typical Low $2.40 Median $2.82 Typical High $7.59 | Professional | None | $2.40 | $2.82 | $7.59 |
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 $3.98 Median $4.79 Typical High $5.75 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $3.98 | $4.79 | $5.75 |
Cigna Setting Facility Modifier None Typical Low $4.57 Median $4.79 Typical High $18.62 | Facility | None | $4.57 | $4.79 | $18.62 |
Cigna Setting Professional Modifier None Typical Low $2.88 Median $3.55 Typical High $33.11 | Professional | None | $2.88 | $3.55 | $33.11 |
United Setting Facility Modifier None Typical Low $2.04 Median $5.13 Typical High $5.62 | Facility | None | $2.04 | $5.13 | $5.62 |
United Setting Professional Modifier None Typical Low $2.40 Median $3.24 Typical High $4.68 | Professional | None | $2.40 | $3.24 | $4.68 |
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 $2.51 Median $3.24 Typical High $3.24 | Professional | 52 · Reduced service | $2.51 | $3.24 | $3.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.00 Median $1.29 Typical High $1.29 | Professional | 53 · Discontinued | $1.00 | $1.29 | $1.29 |
Where Alabama sits
The same service costs 13.5 times more in Vermont 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· 21st of 51
$6.46
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.