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 $22.39 Median $22.39 Typical High $30.20 | Facility | None | $22.39 | $22.39 | $30.20 |
Aetna Setting Professional Modifier None Typical Low $14.13 Median $22.39 Typical High $22.91 | Professional | None | $14.13 | $22.39 | $22.91 |
Ambetter Setting Professional Modifier None Typical Low $13.18 Median $13.18 Typical High $13.18 | Professional | None | $13.18 | $13.18 | $13.18 |
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 $7.24 Median $8.71 Typical High $10.72 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $7.24 | $8.71 | $10.72 |
Cigna Setting Facility Modifier None Typical Low $15.85 Median $16.60 Typical High $63.10 | Facility | None | $15.85 | $16.60 | $63.10 |
Cigna Setting Professional Modifier None Typical Low $10.00 Median $12.02 Typical High $112.20 | Professional | None | $10.00 | $12.02 | $112.20 |
United Setting Facility Modifier None Typical Low $7.08 Median $17.78 Typical High $19.50 | Facility | None | $7.08 | $17.78 | $19.50 |
United Setting Professional Modifier None Typical Low $7.94 Median $8.32 Typical High $14.13 | Professional | None | $7.94 | $8.32 | $14.13 |
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 $8.71 Median $11.22 Typical High $11.22 | Professional | 52 · Reduced service | $8.71 | $11.22 | $11.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.47 Median $4.47 Typical High $4.47 | Professional | 53 · Discontinued | $3.47 | $4.47 | $4.47 |
Where Alabama sits
The same service costs 4.6 times more in Kansas than in Alabama. 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· 51st of 51
$10.47
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.