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 $16.60 Median $19.05 Typical High $25.70 | Facility | None | $16.60 | $19.05 | $25.70 |
Aetna Setting Professional Modifier None Typical Low $10.96 Median $19.05 Typical High $19.05 | Professional | None | $10.96 | $19.05 | $19.05 |
Ambetter Setting Professional Modifier None Typical Low $8.32 Median $10.00 Typical High $22.39 | Professional | None | $8.32 | $10.00 | $22.39 |
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 $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 $13.49 Median $13.80 Typical High $52.48 | Facility | None | $13.49 | $13.80 | $52.48 |
Cigna Setting Professional Modifier None Typical Low $7.24 Median $11.48 Typical High $69.18 | Professional | None | $7.24 | $11.48 | $69.18 |
United Setting Facility Modifier None Typical Low $5.89 Median $14.79 Typical High $16.60 | Facility | None | $5.89 | $14.79 | $16.60 |
United Setting Professional Modifier None Typical Low $8.91 Median $10.00 Typical High $16.60 | Professional | None | $8.91 | $10.00 | $16.60 |
3 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 $6.76 Median $9.55 Typical High $9.55 | Professional | 52 · Reduced service | $6.76 | $9.55 | $9.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.69 Median $3.80 Typical High $3.80 | Professional | 53 · Discontinued | $2.69 | $3.80 | $3.80 |
Ambetter Setting Professional Modifier QW · Waived lab test Typical Low $7.08 Median $8.32 Typical High $20.89 | Professional | QW · Waived lab test | $7.08 | $8.32 | $20.89 |
Where Alabama sits
The same service costs 5.2 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
$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.