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 $5.37 Median $6.17 Typical High $6.61 | Facility | None | $5.37 | $6.17 | $6.61 |
Aetna Setting Professional Modifier None Typical Low $4.37 Median $6.17 Typical High $6.31 | Professional | None | $4.37 | $6.17 | $6.31 |
Ambetter Setting Professional Modifier None Typical Low $3.24 Median $3.63 Typical High $3.72 | Professional | None | $3.24 | $3.63 | $3.72 |
BCBS Alabama Setting Facility Modifier None Typical Low $6.17 Median $6.31 Typical High $6.31 | Facility | None | $6.17 | $6.31 | $6.31 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers Typical Low $2.82 Median $3.47 Typical High $4.17 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $2.82 | $3.47 | $4.17 |
Cigna Setting Facility Modifier None Typical Low $4.37 Median $4.57 Typical High $17.38 | Facility | None | $4.37 | $4.57 | $17.38 |
Cigna Setting Professional Modifier None Typical Low $2.82 Median $3.39 Typical High $30.20 | Professional | None | $2.82 | $3.39 | $30.20 |
United Setting Facility Modifier None Typical Low $69.18 Median $70.79 Typical High $95.50 | Facility | None | $69.18 | $70.79 | $95.50 |
United Setting Professional Modifier None Typical Low $2.24 Median $2.69 Typical High $3.98 | Professional | None | $2.24 | $2.69 | $3.98 |
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 $2.40 Median $3.09 Typical High $3.09 | Professional | 52 · Reduced service | $2.40 | $3.09 | $3.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.95 Median $1.23 Typical High $1.23 | Professional | 53 · Discontinued | $0.95 | $1.23 | $1.23 |
Where Alabama sits
The same service costs 11.2 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· 24th of 51
$6.17
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.