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 $42.66 Median $48.98 Typical High $48.98 | Facility | None | $42.66 | $48.98 | $48.98 |
Aetna Setting Professional Modifier None Typical Low $28.18 Median $48.98 Typical High $48.98 | Professional | None | $28.18 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $17.78 Median $24.55 Typical High $24.55 | Professional | 52 · Reduced service | $17.78 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.08 Median $9.77 Typical High $9.77 | Professional | 53 · Discontinued | $7.08 | $9.77 | $9.77 |
BCBS Alabama Setting Facility Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Facility | None | $39.81 | $39.81 | $39.81 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers Typical Low $29.51 Median $43.65 Typical High $43.65 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $29.51 | $43.65 | $43.65 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $36.31 Typical High $134.90 | Facility | None | $34.67 | $36.31 | $134.90 |
Cigna Setting Professional Modifier None Typical Low $19.50 Median $26.92 Typical High $245.47 | Professional | None | $19.50 | $26.92 | $245.47 |
United Setting Facility Modifier None Typical Low $15.49 Median $38.90 Typical High $42.66 | Facility | None | $15.49 | $38.90 | $42.66 |
United Setting Professional Modifier None Typical Low $17.78 Median $25.70 Typical High $34.67 | Professional | None | $17.78 | $25.70 | $34.67 |
1 more rate 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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier 90 · Outside lab Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | 90 · Outside lab | $21.38 | $21.38 | $21.38 |
Where Alabama sits
The same service costs 4.2 times more in Vermont than in Maryland. 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· 39th of 51
$39.81
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.