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 $11.22 Median $12.88 Typical High $12.88 | Facility | None | $11.22 | $12.88 | $12.88 |
Aetna Setting Professional Modifier None Typical Low $6.03 Median $12.88 Typical High $12.88 | Professional | None | $6.03 | $12.88 | $12.88 |
Ambetter Setting Professional Modifier None Typical Low $5.62 Median $5.62 Typical High $7.76 | Professional | None | $5.62 | $5.62 | $7.76 |
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 $7.76 Median $9.55 Typical High $11.48 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $7.76 | $9.55 | $11.48 |
Cigna Setting Facility Modifier None Typical Low $9.12 Median $9.55 Typical High $36.31 | Facility | None | $9.12 | $9.55 | $36.31 |
Cigna Setting Professional Modifier None Typical Low $5.75 Median $7.08 Typical High $64.57 | Professional | None | $5.75 | $7.08 | $64.57 |
United Setting Facility Modifier None Typical Low $4.07 Median $10.23 Typical High $11.22 | Facility | None | $4.07 | $10.23 | $11.22 |
United Setting Professional Modifier None Typical Low $4.68 Median $6.46 Typical High $9.12 | Professional | None | $4.68 | $6.46 | $9.12 |
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 $5.01 Median $6.46 Typical High $6.46 | Professional | 52 · Reduced service | $5.01 | $6.46 | $6.46 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.00 Median $2.57 Typical High $2.57 | Professional | 53 · Discontinued | $2.00 | $2.57 | $2.57 |
Where Alabama sits
The same service costs 11.7 times more in Vermont 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· 21st of 51
$12.88
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.