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 $14.79 Median $14.79 Typical High $19.95 | Facility | None | $14.79 | $14.79 | $19.95 |
Aetna Setting Professional Modifier None Typical Low $10.47 Median $14.79 Typical High $14.79 | Professional | None | $10.47 | $14.79 | $14.79 |
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 $8.91 Median $10.72 Typical High $13.18 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $8.91 | $10.72 | $13.18 |
Cigna Setting Facility Modifier None Typical Low $10.47 Median $10.96 Typical High $40.74 | Facility | None | $10.47 | $10.96 | $40.74 |
Cigna Setting Professional Modifier None Typical Low $6.61 Median $7.94 Typical High $74.13 | Professional | None | $6.61 | $7.94 | $74.13 |
United Setting Facility Modifier None Typical Low $4.68 Median $11.48 Typical High $12.88 | Facility | None | $4.68 | $11.48 | $12.88 |
United Setting Professional Modifier None Typical Low $5.37 Median $6.46 Typical High $10.47 | Professional | None | $5.37 | $6.46 | $10.47 |
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 $5.75 Median $7.41 Typical High $7.41 | Professional | 52 · Reduced service | $5.75 | $7.41 | $7.41 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.29 Median $2.95 Typical High $2.95 | Professional | 53 · Discontinued | $2.29 | $2.95 | $2.95 |
Ambetter Setting Professional Modifier 90 · Outside lab + GY · Excluded by law Typical Low $8.51 Median $8.51 Typical High $8.51 | Professional | 90 · Outside lab + GY · Excluded by law | $8.51 | $8.51 | $8.51 |
Where Alabama sits
The same service costs 3.0 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· 16th of 51
$14.79
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.