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 $10.23 Typical High $13.80 | Facility | None | $10.23 | $10.23 | $13.80 |
Aetna Setting Professional Modifier None Typical Low $5.89 Median $10.23 Typical High $10.23 | Professional | None | $5.89 | $10.23 | $10.23 |
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 $6.17 Median $7.41 Typical High $9.12 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $6.17 | $7.41 | $9.12 |
Cigna Setting Facility Modifier None Typical Low $7.24 Median $7.59 Typical High $27.54 | Facility | None | $7.24 | $7.59 | $27.54 |
Cigna Setting Professional Modifier None Typical Low $4.57 Median $5.50 Typical High $51.29 | Professional | None | $4.57 | $5.50 | $51.29 |
United Setting Facility Modifier None Typical Low $3.24 Median $7.94 Typical High $8.91 | Facility | None | $3.24 | $7.94 | $8.91 |
United Setting Professional Modifier None Typical Low $3.72 Median $5.13 Typical High $7.24 | Professional | None | $3.72 | $5.13 | $7.24 |
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 $3.98 Median $5.13 Typical High $5.13 | Professional | 52 · Reduced service | $3.98 | $5.13 | $5.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.58 Median $2.04 Typical High $2.04 | Professional | 53 · Discontinued | $1.58 | $2.04 | $2.04 |
Ambetter Setting Professional Modifier 90 · Outside lab Typical Low $4.47 Median $4.47 Typical High $4.47 | Professional | 90 · Outside lab | $4.47 | $4.47 | $4.47 |
Where Alabama sits
The same service costs 4.3 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
$10.23
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.