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 $16.22 Median $16.22 Typical High $21.88 | Facility | None | $16.22 | $16.22 | $21.88 |
Aetna Setting Professional Modifier None Typical Low $9.33 Median $16.22 Typical High $16.22 | Professional | None | $9.33 | $16.22 | $16.22 |
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 $7.24 Median $8.71 Typical High $10.72 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $7.24 | $8.71 | $10.72 |
Cigna Setting Facility Modifier None Typical Low $11.48 Median $12.02 Typical High $45.71 | Facility | None | $11.48 | $12.02 | $45.71 |
Cigna Setting Professional Modifier None Typical Low $5.37 Median $6.46 Typical High $60.26 | Professional | None | $5.37 | $6.46 | $60.26 |
United Setting Facility Modifier None Typical Low $5.13 Median $12.88 Typical High $14.13 | Facility | None | $5.13 | $12.88 | $14.13 |
United Setting Professional Modifier None Typical Low $5.89 Median $6.17 Typical High $8.51 | Professional | None | $5.89 | $6.17 | $8.51 |
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 $5.75 Median $8.13 Typical High $8.13 | Professional | 52 · Reduced service | $5.75 | $8.13 | $8.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.29 Median $3.24 Typical High $3.24 | Professional | 53 · Discontinued | $2.29 | $3.24 | $3.24 |
Ambetter Setting Professional Modifier 90 · Outside lab Typical Low $8.91 Median $8.91 Typical High $8.91 | Professional | 90 · Outside lab | $8.91 | $8.91 | $8.91 |
Where Alabama sits
The same service costs 3.4 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· 17th 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.