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 $6.61 Median $7.59 Typical High $7.76 | Facility | None | $6.61 | $7.59 | $7.76 |
Aetna Setting Professional Modifier None Typical Low $3.55 Median $7.76 Typical High $7.76 | Professional | None | $3.55 | $7.76 | $7.76 |
Ambetter Setting Professional Modifier None Typical Low $3.31 Median $3.31 Typical High $4.68 | Professional | None | $3.31 | $3.31 | $4.68 |
BCBS Alabama Setting Facility Modifier None Typical Low $10.47 Median $10.47 Typical High $10.47 | Facility | None | $10.47 | $10.47 | $10.47 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers Typical Low $4.68 Median $5.62 Typical High $6.76 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $4.68 | $5.62 | $6.76 |
Cigna Setting Facility Modifier None Typical Low $5.37 Median $5.62 Typical High $21.38 | Facility | None | $5.37 | $5.62 | $21.38 |
Cigna Setting Professional Modifier None Typical Low $3.39 Median $4.17 Typical High $37.15 | Professional | None | $3.39 | $4.17 | $37.15 |
United Setting Facility Modifier None Typical Low $2.40 Median $6.03 Typical High $15.14 | Facility | None | $2.40 | $6.03 | $15.14 |
United Setting Professional Modifier None Typical Low $2.82 Median $3.31 Typical High $5.50 | Professional | None | $2.82 | $3.31 | $5.50 |
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 $2.95 Median $3.80 Typical High $3.80 | Professional | 52 · Reduced service | $2.95 | $3.80 | $3.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.20 Median $1.55 Typical High $1.55 | Professional | 53 · Discontinued | $1.20 | $1.55 | $1.55 |
Where Alabama sits
The same service costs 11.0 times more in Vermont than in Kentucky. 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· 19th of 51
$7.76
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.