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 $4.37 Median $4.37 Typical High $5.89 | Facility | None | $4.37 | $4.37 | $5.89 |
Aetna Setting Professional Modifier None Typical Low $3.09 Median $4.37 Typical High $4.37 | Professional | None | $3.09 | $4.37 | $4.37 |
Ambetter Setting Professional Modifier None Typical Low $2.51 Median $2.51 Typical High $2.51 | Professional | None | $2.51 | $2.51 | $2.51 |
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 $2.63 Median $3.24 Typical High $3.89 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $2.63 | $3.24 | $3.89 |
Cigna Setting Facility Modifier None Typical Low $3.09 Median $3.24 Typical High $12.30 | Facility | None | $3.09 | $3.24 | $12.30 |
Cigna Setting Professional Modifier None Typical Low $2.04 Median $2.29 Typical High $22.39 | Professional | None | $2.04 | $2.29 | $22.39 |
United Setting Facility Modifier None Typical Low $416.87 Median $436.52 Typical High $575.44 | Facility | None | $416.87 | $436.52 | $575.44 |
United Setting Professional Modifier None Typical Low $1.62 Median $2.19 Typical High $3.16 | Professional | None | $1.62 | $2.19 | $3.16 |
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 $1.70 Median $2.19 Typical High $2.19 | Professional | 52 · Reduced service | $1.70 | $2.19 | $2.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.68 Median $0.87 Typical High $0.87 | Professional | 53 · Discontinued | $0.68 | $0.87 | $0.87 |
Where Alabama sits
The same service costs 4.2 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· 16th of 51
$4.57
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.