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 $16.60 Typical High $17.38 | Facility | None | $14.13 | $16.60 | $17.38 |
Aetna Setting Professional Modifier None Typical Low $9.55 Median $16.60 Typical High $16.98 | Professional | None | $9.55 | $16.60 | $16.98 |
Ambetter Setting Professional Modifier None Typical Low $5.75 Median $7.08 Typical High $9.55 | Professional | None | $5.75 | $7.08 | $9.55 |
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 $11.48 Median $12.02 Typical High $45.71 | Facility | None | $11.48 | $12.02 | $45.71 |
Cigna Setting Professional Modifier None Typical Low $7.24 Median $8.91 Typical High $81.28 | Professional | None | $7.24 | $8.91 | $81.28 |
United Setting Facility Modifier None Typical Low $5.13 Median $12.88 Typical High $14.13 | Facility | None | $5.13 | $12.88 | $14.13 |
United Setting Professional Modifier None Typical Low $6.03 Median $7.08 Typical High $10.47 | Professional | None | $6.03 | $7.08 | $10.47 |
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 $6.31 Median $8.13 Typical High $8.13 | Professional | 52 · Reduced service | $6.31 | $8.13 | $8.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.51 Median $3.31 Typical High $3.31 | Professional | 53 · Discontinued | $2.51 | $3.31 | $3.31 |
Where Alabama sits
The same service costs 9.5 times more in Vermont than in Indiana. 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· 26th 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.