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 $19.95 Median $22.91 Typical High $109.65 | Facility | None | $19.95 | $22.91 | $109.65 |
Aetna Setting Professional Modifier None Typical Low $10.00 Median $22.91 Typical High $30.20 | Professional | None | $10.00 | $22.91 | $30.20 |
Ambetter Setting Professional Modifier None Typical Low $16.98 Median $16.98 Typical High $19.95 | Professional | None | $16.98 | $16.98 | $19.95 |
BCBS Alabama Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Facility | None | $56.23 | $56.23 | $56.23 |
BCBS Alabama Setting Professional Modifier 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 93 · Audio-only telehealth + 99 · Multiple modifiers Typical Low $19.05 Median $22.39 Typical High $29.51 | Professional | 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 93 · Audio-only telehealth + 99 · Multiple modifiers | $19.05 | $22.39 | $29.51 |
Cigna Setting Professional Modifier None Typical Low $19.05 Median $22.91 Typical High $58.88 | Professional | None | $19.05 | $22.91 | $58.88 |
United Setting Facility Modifier None Typical Low $83.18 Median $87.10 Typical High $114.82 | Facility | None | $83.18 | $87.10 | $114.82 |
United Setting Professional Modifier None Typical Low $13.49 Median $14.45 Typical High $25.70 | Professional | None | $13.49 | $14.45 | $25.70 |
4 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 $11.48 Median $11.48 Typical High $11.48 | Professional | 52 · Reduced service | $11.48 | $11.48 | $11.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.57 Median $4.57 Typical High $4.57 | Professional | 53 · Discontinued | $4.57 | $4.57 | $4.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.47 Median $3.47 Typical High $3.47 | Professional | 55 · Aftercare only | $3.47 | $3.47 | $3.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.29 Median $2.29 Typical High $2.29 | Professional | 56 · Pre-op care only | $2.29 | $2.29 | $2.29 |
Where Alabama sits
The same service costs 5.4 times more in Vermont than in Kansas. 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· 3rd of 51
$56.23
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.