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 $4.79 Median $5.01 Typical High $6.76 | Facility | None | $4.79 | $5.01 | $6.76 |
Aetna Setting Professional Modifier None Typical Low $2.34 Median $5.01 Typical High $5.01 | Professional | None | $2.34 | $5.01 | $5.01 |
Ambetter Setting Professional Modifier None Typical Low $2.19 Median $2.19 Typical High $5.89 | Professional | None | $2.19 | $2.19 | $5.89 |
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 $3.09 Median $3.72 Typical High $4.47 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $3.09 | $3.72 | $4.47 |
Cigna Setting Facility Modifier None Typical Low $3.55 Median $3.72 Typical High $14.45 | Facility | None | $3.55 | $3.72 | $14.45 |
Cigna Setting Professional Modifier None Typical Low $2.29 Median $2.75 Typical High $25.70 | Professional | None | $2.29 | $2.75 | $25.70 |
United Setting Facility Modifier None Typical Low $1.58 Median $3.98 Typical High $15.14 | Facility | None | $1.58 | $3.98 | $15.14 |
United Setting Professional Modifier None Typical Low $1.86 Median $2.51 Typical High $3.63 | Professional | None | $1.86 | $2.51 | $3.63 |
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 $1.95 Median $2.51 Typical High $2.51 | Professional | 52 · Reduced service | $1.95 | $2.51 | $2.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.78 Median $1.00 Typical High $1.00 | Professional | 53 · Discontinued | $0.78 | $1.00 | $1.00 |
Where Alabama sits
The same service costs 4.2 times more in Kansas 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· 20th of 51
$5.01
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.