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 $27.54 Median $27.54 Typical High $37.15 | Facility | None | $27.54 | $27.54 | $37.15 |
Aetna Setting Professional Modifier None Typical Low $15.85 Median $27.54 Typical High $27.54 | Professional | None | $15.85 | $27.54 | $27.54 |
BCBS Alabama Setting Facility Modifier None Typical Low $15.14 Median $15.14 Typical High $15.14 | Facility | None | $15.14 | $15.14 | $15.14 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers Typical Low $9.55 Median $11.48 Typical High $14.13 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $9.55 | $11.48 | $14.13 |
Cigna Setting Facility Modifier None Typical Low $19.50 Median $20.42 Typical High $52.48 | Facility | None | $19.50 | $20.42 | $52.48 |
Cigna Setting Professional Modifier None Typical Low $12.88 Median $12.88 Typical High $21.38 | Professional | None | $12.88 | $12.88 | $21.38 |
United Setting Facility Modifier None Typical Low $8.71 Median $21.88 Typical High $23.99 | Facility | None | $8.71 | $21.88 | $23.99 |
United Setting Professional Modifier None Typical Low $10.00 Median $13.80 Typical High $19.95 | Professional | None | $10.00 | $13.80 | $19.95 |
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 $10.72 Median $13.80 Typical High $13.80 | Professional | 52 · Reduced service | $10.72 | $13.80 | $13.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.27 Median $5.50 Typical High $5.50 | Professional | 53 · Discontinued | $4.27 | $5.50 | $5.50 |
Ambetter Setting Professional Modifier 33 · Preventive service Typical Low $14.45 Median $16.22 Typical High $16.60 | Professional | 33 · Preventive service | $14.45 | $16.22 | $16.60 |
Where Alabama sits
The same service costs 3.6 times more in Hawaii 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· 50th of 51
$15.14
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.