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 $14.13 Median $14.13 Typical High $19.05 | Facility | None | $14.13 | $14.13 | $19.05 |
Aetna Setting Professional Modifier None Typical Low $6.61 Median $14.13 Typical High $14.13 | Professional | None | $6.61 | $14.13 | $14.13 |
Ambetter Setting Professional Modifier None Typical Low $7.41 Median $8.32 Typical High $8.51 | Professional | None | $7.41 | $8.32 | $8.51 |
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 $8.71 Median $10.47 Typical High $12.59 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $8.71 | $10.47 | $12.59 |
Cigna Setting Facility Modifier None Typical Low $10.00 Median $10.47 Typical High $38.90 | Facility | None | $10.00 | $10.47 | $38.90 |
Cigna Setting Professional Modifier None Typical Low $6.31 Median $7.76 Typical High $70.79 | Professional | None | $6.31 | $7.76 | $70.79 |
United Setting Facility Modifier None Typical Low $4.47 Median $11.22 Typical High $12.30 | Facility | None | $4.47 | $11.22 | $12.30 |
United Setting Professional Modifier None Typical Low $5.25 Median $6.17 Typical High $10.00 | Professional | None | $5.25 | $6.17 | $10.00 |
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 $5.50 Median $7.08 Typical High $7.08 | Professional | 52 · Reduced service | $5.50 | $7.08 | $7.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.19 Median $2.82 Typical High $2.82 | Professional | 53 · Discontinued | $2.19 | $2.82 | $2.82 |
Where Alabama sits
The same service costs 8.5 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· 17th of 51
$14.13
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.