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 $11.75 Median $13.49 Typical High $13.49 | Facility | None | $11.75 | $13.49 | $13.49 |
Aetna Setting Professional Modifier None Typical Low $6.31 Median $13.49 Typical High $13.49 | Professional | None | $6.31 | $13.49 | $13.49 |
Ambetter Setting Professional Modifier None Typical Low $5.89 Median $5.89 Typical High $8.13 | Professional | None | $5.89 | $5.89 | $8.13 |
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 $8.13 Median $10.00 Typical High $12.02 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $8.13 | $10.00 | $12.02 |
Cigna Setting Facility Modifier None Typical Low $9.55 Median $10.00 Typical High $37.15 | Facility | None | $9.55 | $10.00 | $37.15 |
Cigna Setting Professional Modifier None Typical Low $6.03 Median $7.41 Typical High $67.61 | Professional | None | $6.03 | $7.41 | $67.61 |
United Setting Facility Modifier None Typical Low $4.27 Median $10.47 Typical High $11.75 | Facility | None | $4.27 | $10.47 | $11.75 |
United Setting Professional Modifier None Typical Low $4.90 Median $6.76 Typical High $9.55 | Professional | None | $4.90 | $6.76 | $9.55 |
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 $5.25 Median $6.76 Typical High $6.76 | Professional | 52 · Reduced service | $5.25 | $6.76 | $6.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.09 Median $2.69 Typical High $2.69 | Professional | 53 · Discontinued | $2.09 | $2.69 | $2.69 |
Where Alabama sits
The same service costs 4.5 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· 19th of 51
$13.49
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.