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 $20.42 Median $25.12 Typical High $25.12 | Professional | None | $20.42 | $25.12 | $25.12 |
Ambetter Setting Professional Modifier None Typical Low $9.33 Median $9.33 Typical High $10.96 | Professional | None | $9.33 | $9.33 | $10.96 |
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 Professional Modifier None Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | None | $22.39 | $22.39 | $22.39 |
United Setting Facility Modifier None Typical Low $19.05 Median $23.99 Typical High $23.99 | Facility | None | $19.05 | $23.99 | $23.99 |
United Setting Professional Modifier None Typical Low $14.79 Median $18.20 Typical High $28.84 | Professional | None | $14.79 | $18.20 | $28.84 |
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 Facility Modifier 53 · Discontinued Typical Low $5.13 Median $5.13 Typical High $6.76 | Facility | 53 · Discontinued | $5.13 | $5.13 | $6.76 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $8.51 Median $12.59 Typical High $12.59 | Professional | 52 · Reduced service | $8.51 | $12.59 | $12.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.39 Median $5.13 Typical High $5.13 | Professional | 53 · Discontinued | $3.39 | $5.13 | $5.13 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers Typical Low $15.49 Median $22.91 Typical High $22.91 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $15.49 | $22.91 | $22.91 |
Where Alabama sits
The same service costs 5.2 times more in Texas than in New Jersey. 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· 36th 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.