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 $38.90 Median $45.71 Typical High $60.26 | Facility | None | $38.90 | $45.71 | $60.26 |
Aetna Setting Professional Modifier None Typical Low $18.20 Median $45.71 Typical High $45.71 | Professional | None | $18.20 | $45.71 | $45.71 |
Ambetter Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | None | $15.14 | $15.14 | $15.14 |
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 02 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 34 + 41 + 49 + 52 · Reduced service + 55 · Aftercare only + 92 · Alternate lab platform Typical Low $21.88 Median $26.30 Typical High $26.92 | Professional | 02 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 34 + 41 + 49 + 52 · Reduced service + 55 · Aftercare only + 92 · Alternate lab platform | $21.88 | $26.30 | $26.92 |
Cigna Setting Facility Modifier None Typical Low $28.84 Median $29.51 Typical High $112.20 | Facility | None | $28.84 | $29.51 | $112.20 |
Cigna Setting Professional Modifier None Typical Low $16.22 Median $23.44 Typical High $40.74 | Professional | None | $16.22 | $23.44 | $40.74 |
United Setting Facility Modifier None Typical Low $12.59 Median $31.62 Typical High $35.48 | Facility | None | $12.59 | $31.62 | $35.48 |
United Setting Professional Modifier None Typical Low $16.98 Median $19.05 Typical High $26.92 | Professional | None | $16.98 | $19.05 | $26.92 |
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 $22.39 Median $22.39 Typical High $22.39 | Professional | 52 · Reduced service | $22.39 | $22.39 | $22.39 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $9.12 Typical High $9.12 | Professional | 53 · Discontinued | $9.12 | $9.12 | $9.12 |
Where Alabama sits
The same service costs 4.5 times more in Alaska 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
$17.78
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.