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 $8.13 Median $9.33 Typical High $12.59 | Facility | None | $8.13 | $9.33 | $12.59 |
Aetna Setting Professional Modifier None Typical Low $4.27 Median $9.33 Typical High $9.33 | Professional | None | $4.27 | $9.33 | $9.33 |
Ambetter Setting Professional Modifier None Typical Low $5.37 Median $5.37 Typical High $5.62 | Professional | None | $5.37 | $5.37 | $5.62 |
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 $5.62 Median $6.76 Typical High $8.32 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $5.62 | $6.76 | $8.32 |
Cigna Setting Facility Modifier None Typical Low $6.61 Median $6.76 Typical High $25.70 | Facility | None | $6.61 | $6.76 | $25.70 |
Cigna Setting Professional Modifier None Typical Low $4.17 Median $5.13 Typical High $46.77 | Professional | None | $4.17 | $5.13 | $46.77 |
United Setting Facility Modifier None Typical Low $2.88 Median $7.24 Typical High $60.26 | Facility | None | $2.88 | $7.24 | $60.26 |
United Setting Professional Modifier None Typical Low $3.39 Median $4.57 Typical High $6.61 | Professional | None | $3.39 | $4.57 | $6.61 |
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 $3.63 Median $4.68 Typical High $4.68 | Professional | 52 · Reduced service | $3.63 | $4.68 | $4.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.45 Median $1.86 Typical High $1.86 | Professional | 53 · Discontinued | $1.45 | $1.86 | $1.86 |
Where Alabama sits
The same service costs 5.6 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· 19th of 51
$9.33
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.