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 $5.75 Median $6.76 Typical High $6.92 | Facility | None | $5.75 | $6.76 | $6.92 |
Aetna Setting Professional Modifier None Typical Low $3.89 Median $6.76 Typical High $6.76 | Professional | None | $3.89 | $6.76 | $6.76 |
Ambetter Setting Professional Modifier None Typical Low $2.45 Median $3.63 Typical High $7.94 | Professional | None | $2.45 | $3.63 | $7.94 |
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 $2.95 Median $3.63 Typical High $4.37 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $2.95 | $3.63 | $4.37 |
Cigna Setting Facility Modifier None Typical Low $4.68 Median $4.90 Typical High $18.62 | Facility | None | $4.68 | $4.90 | $18.62 |
Cigna Setting Professional Modifier None Typical Low $2.51 Median $4.07 Typical High $23.99 | Professional | None | $2.51 | $4.07 | $23.99 |
United Setting Facility Modifier None Typical Low $2.09 Median $5.25 Typical High $12.02 | Facility | None | $2.09 | $5.25 | $12.02 |
United Setting Professional Modifier None Typical Low $3.02 Median $3.47 Typical High $6.03 | Professional | None | $3.02 | $3.47 | $6.03 |
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 $2.40 Median $3.39 Typical High $3.39 | Professional | 52 · Reduced service | $2.40 | $3.39 | $3.39 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.95 Median $1.35 Typical High $1.35 | Professional | 53 · Discontinued | $0.95 | $1.35 | $1.35 |
Where Alabama sits
The same service costs 7.9 times more in Minnesota than in New York. 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· 14th of 51
$6.76
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.