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 $23.44 Median $23.44 Typical High $30.90 | Facility | None | $23.44 | $23.44 | $30.90 |
Aetna Setting Professional Modifier None Typical Low $13.49 Median $23.44 Typical High $23.44 | Professional | None | $13.49 | $23.44 | $23.44 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $7.94 Median $11.75 Typical High $11.75 | Professional | 52 · Reduced service | $7.94 | $11.75 | $11.75 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.16 Median $4.68 Typical High $4.68 | Professional | 53 · Discontinued | $3.16 | $4.68 | $4.68 |
Ambetter Setting Professional Modifier None Typical Low $10.23 Median $10.23 Typical High $27.54 | Professional | None | $10.23 | $10.23 | $27.54 |
BCBS Alabama Setting Facility Modifier None Typical Low $25.12 Median $25.12 Typical High $25.12 | Facility | None | $25.12 | $25.12 | $25.12 |
Cigna Setting Facility Modifier None Typical Low $16.60 Median $16.98 Typical High $64.57 | Facility | None | $16.60 | $16.98 | $64.57 |
Cigna Setting Professional Modifier None Typical Low $8.91 Median $14.45 Typical High $162.18 | Professional | None | $8.91 | $14.45 | $162.18 |
United Setting Facility Modifier None Typical Low $7.24 Median $18.20 Typical High $20.42 | Facility | None | $7.24 | $18.20 | $20.42 |
United Setting Professional Modifier None Typical Low $12.02 Median $20.42 Typical High $29.51 | Professional | None | $12.02 | $20.42 | $29.51 |
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 |
|---|---|---|---|---|---|
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers Typical Low $19.05 Median $30.20 Typical High $30.20 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $19.05 | $30.20 | $30.20 |
Where Alabama sits
The same service costs 4.6 times more in Vermont than in Illinois. 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· 29th of 51
$25.12
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.