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 $51.29 Median $51.29 Typical High $51.29 | Facility | None | $51.29 | $51.29 | $51.29 |
Aetna Setting Professional Modifier None (both parts) Typical Low $51.29 Median $51.29 Typical High $51.29 | Professional | None (both parts) | $51.29 | $51.29 | $51.29 |
BCBS Alabama Setting Facility Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Facility | None | $39.81 | $39.81 | $39.81 |
BCBS Alabama Setting Professional Modifier 02 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 34 + 41 + 49 + 52 · Reduced service + 55 · Aftercare only + 92 · Alternate lab platform Typical Low $31.62 Median $38.90 Typical High $38.90 | Professional | 02 + 17 + 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 34 + 41 + 49 + 52 · Reduced service + 55 · Aftercare only + 92 · Alternate lab platform | $31.62 | $38.90 | $38.90 |
Cigna Setting Facility Modifier None Typical Low $41.69 Median $43.65 Typical High $162.18 | Facility | None | $41.69 | $43.65 | $162.18 |
Cigna Setting Professional Modifier None (both parts) Typical Low $51.29 Median $51.29 Typical High $51.29 | Professional | None (both parts) | $51.29 | $51.29 | $51.29 |
United Setting Facility Modifier None Typical Low $18.62 Median $45.71 Typical High $51.29 | Facility | None | $18.62 | $45.71 | $51.29 |
United Setting Professional Modifier None (both parts) Typical Low $21.38 Median $28.18 Typical High $51.29 | Professional | None (both parts) | $21.38 | $28.18 | $51.29 |
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 $25.70 Median $25.70 Typical High $25.70 | Professional | 52 · Reduced service | $25.70 | $25.70 | $25.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $10.23 Typical High $10.23 | Professional | 53 · Discontinued | $10.23 | $10.23 | $10.23 |
Ambetter Setting Professional Modifier QW · Waived lab test Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | QW · Waived lab test | $25.70 | $25.70 | $25.70 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $5.01 Median $5.01 Typical High $5.01 | Professional | 26 · Professional part | $5.01 | $5.01 | $5.01 |
Where Alabama sits
The same service costs 3.1 times more in Alaska than in Maine. 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· 48th of 51
$39.81
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.