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 $18.62 Median $18.62 Typical High $24.55 | Facility | None | $18.62 | $18.62 | $24.55 |
Aetna Setting Professional Modifier None Typical Low $10.72 Median $18.62 Typical High $18.62 | Professional | None | $10.72 | $18.62 | $18.62 |
Ambetter Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $19.95 | Professional | None | $18.62 | $18.62 | $19.95 |
BCBS Setting Facility Modifier None Typical Low $10.47 Median $10.47 Typical High $10.47 | Facility | None | $10.47 | $10.47 | $10.47 |
BCBS Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers Typical Low $7.59 Median $9.12 Typical High $11.22 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $7.59 | $9.12 | $11.22 |
Cigna Setting Facility Modifier None Typical Low $13.18 Median $13.49 Typical High $51.29 | Facility | None | $13.18 | $13.49 | $51.29 |
Cigna Setting Professional Modifier None Typical Low $6.17 Median $7.59 Typical High $69.18 | Professional | None | $6.17 | $7.59 | $69.18 |
United Setting Facility Modifier None Typical Low $5.75 Median $14.45 Typical High $16.22 | Facility | None | $5.75 | $14.45 | $16.22 |
United Setting Professional Modifier None Typical Low $6.76 Median $7.94 Typical High $9.77 | Professional | None | $6.76 | $7.94 | $9.77 |
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 $6.61 Median $9.33 Typical High $9.33 | Professional | 52 · Reduced service | $6.61 | $9.33 | $9.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.63 Median $3.72 Typical High $3.72 | Professional | 53 · Discontinued | $2.63 | $3.72 | $3.72 |
Where Alabama sits
The same service costs 3.5 times more in Alaska 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· 50th 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.