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 Professional Modifier None Typical Low $3.31 Median $10.96 Typical High $13.80 | Professional | None | $3.31 | $10.96 | $13.80 |
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 $12.02 Median $13.18 Typical High $17.38 | Professional | 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 93 · Audio-only telehealth + 99 · Multiple modifiers | $12.02 | $13.18 | $17.38 |
Cigna Setting Professional Modifier None Typical Low $8.51 Median $12.02 Typical High $30.20 | Professional | None | $8.51 | $12.02 | $30.20 |
United Setting Professional Modifier None Typical Low $8.91 Median $12.02 Typical High $12.88 | Professional | None | $8.91 | $12.02 | $12.88 |
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 $5.50 Median $5.50 Typical High $5.50 | Professional | 52 · Reduced service | $5.50 | $5.50 | $5.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.19 Median $2.19 Typical High $2.19 | Professional | 53 · Discontinued | $2.19 | $2.19 | $2.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.66 Median $1.66 Typical High $1.66 | Professional | 55 · Aftercare only | $1.66 | $1.66 | $1.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.10 Median $1.10 Typical High $1.10 | Professional | 56 · Pre-op care only | $1.10 | $1.10 | $1.10 |
Where Alabama sits
The same service costs 6.6 times more in Alabama than in Kentucky. 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· 1st 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.