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 $8.91 Median $8.91 Typical High $12.02 | Facility | None | $8.91 | $8.91 | $12.02 |
Aetna Setting Professional Modifier None Typical Low $6.31 Median $8.91 Typical High $8.91 | Professional | None | $6.31 | $8.91 | $8.91 |
Ambetter Setting Professional Modifier None Typical Low $5.13 Median $5.13 Typical High $5.37 | Professional | None | $5.13 | $5.13 | $5.37 |
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 $5.37 Median $6.46 Typical High $7.94 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $5.37 | $6.46 | $7.94 |
Cigna Setting Facility Modifier None Typical Low $6.31 Median $6.46 Typical High $24.55 | Facility | None | $6.31 | $6.46 | $24.55 |
Cigna Setting Professional Modifier None Typical Low $3.89 Median $4.79 Typical High $43.65 | Professional | None | $3.89 | $4.79 | $43.65 |
United Setting Facility Modifier None Typical Low $2.75 Median $6.92 Typical High $15.14 | Facility | None | $2.75 | $6.92 | $15.14 |
United Setting Professional Modifier None Typical Low $3.24 Median $4.37 Typical High $6.31 | Professional | None | $3.24 | $4.37 | $6.31 |
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 $3.47 Median $4.47 Typical High $4.47 | Professional | 52 · Reduced service | $3.47 | $4.47 | $4.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.38 Median $1.78 Typical High $1.78 | Professional | 53 · Discontinued | $1.38 | $1.78 | $1.78 |
Where Alabama sits
The same service costs 3.2 times more in Alaska 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· 18th of 51
$8.91
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.