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 $3.47 Median $3.47 Typical High $4.79 | Facility | None | $3.47 | $3.47 | $4.79 |
Aetna Setting Professional Modifier None Typical Low $2.00 Median $3.47 Typical High $3.55 | Professional | None | $2.00 | $3.47 | $3.55 |
Ambetter Setting Professional Modifier None Typical Low $1.51 Median $1.51 Typical High $4.07 | Professional | None | $1.51 | $1.51 | $4.07 |
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 $2.04 Median $2.51 Typical High $3.02 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $2.04 | $2.51 | $3.02 |
Cigna Setting Facility Modifier None Typical Low $2.45 Median $2.51 Typical High $9.33 | Facility | None | $2.45 | $2.51 | $9.33 |
Cigna Setting Professional Modifier None Typical Low $1.48 Median $1.86 Typical High $16.60 | Professional | None | $1.48 | $1.86 | $16.60 |
United Setting Facility Modifier None Typical Low $43.65 Median $44.67 Typical High $60.26 | Facility | None | $43.65 | $44.67 | $60.26 |
United Setting Professional Modifier None Typical Low $1.26 Median $1.70 Typical High $2.45 | Professional | None | $1.26 | $1.70 | $2.45 |
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 $1.32 Median $1.74 Typical High $1.74 | Professional | 52 · Reduced service | $1.32 | $1.74 | $1.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.52 Median $0.69 Typical High $0.69 | Professional | 53 · Discontinued | $0.52 | $0.69 | $0.69 |
Where Alabama sits
The same service costs 28.2 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· 28th of 51
$3.47
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.