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 $13.18 Median $13.18 Typical High $17.78 | Facility | None | $13.18 | $13.18 | $17.78 |
Aetna Setting Professional Modifier None Typical Low $9.33 Median $13.18 Typical High $13.18 | Professional | None | $9.33 | $13.18 | $13.18 |
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 $7.94 Median $9.55 Typical High $11.75 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $7.94 | $9.55 | $11.75 |
Cigna Setting Facility Modifier None Typical Low $9.33 Median $9.77 Typical High $36.31 | Facility | None | $9.33 | $9.77 | $36.31 |
Cigna Setting Professional Modifier None Typical Low $5.89 Median $7.08 Typical High $66.07 | Professional | None | $5.89 | $7.08 | $66.07 |
United Setting Facility Modifier None Typical Low $4.17 Median $10.23 Typical High $11.48 | Facility | None | $4.17 | $10.23 | $11.48 |
United Setting Professional Modifier None Typical Low $4.79 Median $5.75 Typical High $9.33 | Professional | None | $4.79 | $5.75 | $9.33 |
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 $5.13 Median $6.61 Typical High $6.61 | Professional | 52 · Reduced service | $5.13 | $6.61 | $6.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.04 Median $2.63 Typical High $2.63 | Professional | 53 · Discontinued | $2.04 | $2.63 | $2.63 |
Ambetter Setting Professional Modifier 90 · Outside lab Typical Low $7.59 Median $7.59 Typical High $7.59 | Professional | 90 · Outside lab | $7.59 | $7.59 | $7.59 |
Where Alabama sits
The same service costs 3.2 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· 17th of 51
$13.18
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.