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 $5.50 Median $5.50 Typical High $7.24 | Facility | None | $5.50 | $5.50 | $7.24 |
Aetna Setting Professional Modifier None Typical Low $3.16 Median $5.50 Typical High $5.50 | Professional | None | $3.16 | $5.50 | $5.50 |
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 $3.31 Median $3.98 Typical High $4.79 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $3.31 | $3.98 | $4.79 |
Cigna Setting Facility Modifier None Typical Low $3.89 Median $3.98 Typical High $15.49 | Facility | None | $3.89 | $3.98 | $15.49 |
Cigna Setting Professional Modifier None Typical Low $2.40 Median $2.95 Typical High $26.92 | Professional | None | $2.40 | $2.95 | $26.92 |
United Setting Facility Modifier None Typical Low $1.70 Median $3.02 Typical High $4.79 | Facility | None | $1.70 | $3.02 | $4.79 |
United Setting Professional Modifier None Typical Low $2.00 Median $2.69 Typical High $3.89 | Professional | None | $2.00 | $2.69 | $3.89 |
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 $2.09 Median $2.75 Typical High $2.75 | Professional | 52 · Reduced service | $2.09 | $2.75 | $2.75 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.83 Median $1.10 Typical High $1.10 | Professional | 53 · Discontinued | $0.83 | $1.10 | $1.10 |
Where Alabama sits
The same service costs 9.1 times more in Kansas 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· 13th of 51
$5.50
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.