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 $10.23 Median $11.75 Typical High $11.75 | Facility | None | $10.23 | $11.75 | $11.75 |
Aetna Setting Professional Modifier None Typical Low $5.37 Median $11.75 Typical High $11.75 | Professional | None | $5.37 | $11.75 | $11.75 |
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 $4.07 Median $4.90 Typical High $5.89 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $4.07 | $4.90 | $5.89 |
Cigna Setting Facility Modifier None Typical Low $8.32 Median $8.71 Typical High $31.62 | Facility | None | $8.32 | $8.71 | $31.62 |
Cigna Setting Professional Modifier None Typical Low $5.25 Median $6.31 Typical High $58.88 | Professional | None | $5.25 | $6.31 | $58.88 |
United Setting Facility Modifier None Typical Low $3.63 Median $9.12 Typical High $10.23 | Facility | None | $3.63 | $9.12 | $10.23 |
United Setting Professional Modifier None Typical Low $4.27 Median $4.47 Typical High $7.94 | Professional | None | $4.27 | $4.47 | $7.94 |
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 $4.47 Median $5.89 Typical High $5.89 | Professional | 52 · Reduced service | $4.47 | $5.89 | $5.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.82 Median $2.34 Typical High $2.34 | Professional | 53 · Discontinued | $1.82 | $2.34 | $2.34 |
Ambetter Setting Professional Modifier 90 · Outside lab Typical Low $5.13 Median $5.13 Typical High $5.13 | Professional | 90 · Outside lab | $5.13 | $5.13 | $5.13 |
Where Alabama sits
The same service costs 3.0 times more in Alaska 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· 15th of 51
$11.75
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.