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 $15.85 Median $16.60 Typical High $22.39 | Facility | None | $15.85 | $16.60 | $22.39 |
Aetna Setting Professional Modifier None Typical Low $7.59 Median $16.60 Typical High $16.60 | Professional | None | $7.59 | $16.60 | $16.60 |
Ambetter Setting Professional Modifier None Typical Low $8.71 Median $9.55 Typical High $10.00 | Professional | None | $8.71 | $9.55 | $10.00 |
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 $10.00 Median $12.02 Typical High $14.79 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $10.00 | $12.02 | $14.79 |
Cigna Setting Facility Modifier None Typical Low $11.75 Median $12.02 Typical High $45.71 | Facility | None | $11.75 | $12.02 | $45.71 |
Cigna Setting Professional Modifier None Typical Low $7.41 Median $8.91 Typical High $83.18 | Professional | None | $7.41 | $8.91 | $83.18 |
United Setting Facility Modifier None Typical Low $5.13 Median $12.88 Typical High $14.45 | Facility | None | $5.13 | $12.88 | $14.45 |
United Setting Professional Modifier None Typical Low $6.03 Median $7.24 Typical High $11.75 | Professional | None | $6.03 | $7.24 | $11.75 |
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 $6.46 Median $8.32 Typical High $8.32 | Professional | 52 · Reduced service | $6.46 | $8.32 | $8.32 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.57 Median $3.31 Typical High $3.31 | Professional | 53 · Discontinued | $2.57 | $3.31 | $3.31 |
Where Alabama sits
The same service costs 4.0 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· 22nd 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.