Commercial healthcare reimbursement in Alabama
How Alabama compares with the nation, by payer, specialty and procedure.
Alabama at a glance
What the data shows
Alabama ranks 44th of 51 states for commercial reimbursement, with an index of 87 (100 = national median) across 228 procedure codes; the South region averages 94.
Commercial rates in Alabama run a median 128% of Medicare.
Aetna has the highest index in the state (100) and Cigna the lowest (86), a 14-point gap, in the files analyzed.
CPT 67036 (Removal of inner eye fluid) is the strongest relative to the national median (154% of it, a 54% premium); CPT 11102 (Tangntl bx skin single les) is furthest below (59% of the national median, 41% lower).
By specialty, Alabama is strongest for gastroenterology (ranks 29th of 50 states for that specialty) and weakest for internal medicine (51st of 51).
Against Medicare, gastroenterology has the highest ratio in Alabama (169% of Medicare) and internal medicine the lowest (78%).
Payer ranking in Alabama
| Payer | Index | Rank | Level | Codes | Providers | TINs |
|---|---|---|---|---|---|---|
| Aetna | 100 | 1 | 228 | 847 | 648 | |
| Blue Cross Blue Shield | 100 | 1 | 227 | 852 | 610 | |
| UnitedHealthcare | 96 | 3 | 228 | 719 | 501 | |
| Cigna | 86 | 4 | 228 | 837 | 556 |
Reimbursement index by specialty in Alabama
| Specialty | Index | Rank among states | % of Medicare | Level | Codes | Providers |
|---|---|---|---|---|---|---|
| Gastroenterology | 96 | 29 of 50 | 169% | 36 | 115 | |
| Ophthalmology | 94 | 30 of 50 | 126% | 42 | 113 | |
| Orthopedic surgery | 94 | 32 of 51 | 126% | 39 | 118 | |
| Cardiology | 87 | 44 of 51 | 122% | 38 | 127 | |
| Urology | 80 | 48 of 50 | 148% | 37 | 117 | |
| Dermatology | 77 | 48 of 50 | 79% | 44 | 131 | |
| Diagnostic radiology | 79 | 49 of 51 | 127% | 49 | 127 | |
| Internal medicine | 66 | 51 of 51 | 78% | 25 | 105 |
Specialty by payer in Alabama
| Specialty | UHC | Aetna | Cigna | BCBS |
|---|---|---|---|---|
| Internal medicine | 66 | 58 | 62 | 74 |
| Dermatology | 92 | 66 | 67 | 74 |
| Ophthalmology | 85 | 93 | 80 | 107 |
| Cardiology | 81 | 101 | 81 | 71 |
| Orthopedic surgery | 89 | 96 | 69 | 96 |
| Diagnostic radiology | 75 | 80 | 71 | 71 |
| Urology | 87 | 86 | 69 | 75 |
| Gastroenterology | 82 | 91 | 67 | 96 |
Alabama compared with South region states
Procedures that pay most and least in Alabama vs the nation
Highest vs national
| Code | Alabama | National | Gap | Prov. |
|---|---|---|---|---|
| 67036 Removal of inner eye fluid | $1,718 | $1,117 | +54% | 111 |
| 67042 Vit for macular hole | $2,194 | $1,494 | +47% | 111 |
| 67210 Treatment of retinal lesion | $954 | $659 | +45% | 111 |
| 67108 Repair detached retina | $2,286 | $1,594 | +43% | 111 |
| 76512 Oph us dx b-scan | $99 | $70 | +41% | 109 |
| 67904 Repair eyelid defect | $1,135 | $816 | +39% | 111 |
| 66984 Xcapsl ctrc rmvl w/o ecp | $987 | $738 | +34% | 111 |
| 67028 Injection eye drug | $179 | $137 | +31% | 111 |
| 93298 Rem interrog dev eval scrms | $68 | $52 | +30% | 126 |
| 65855 Trabeculoplasty laser surg | $396 | $307 | +29% | 111 |
| 66991 Xcapsl ctrc rmvl insj 1+ | $1,080 | $840 | +29% | 109 |
| 77280 Ther rad simulaj field smpl | $387 | $302 | +28% | 131 |
| 52649 Prostate laser enucleation | $1,612 | $1,355 | +19% | 116 |
| 43246 Egd place gastrostomy tube | $400 | $338 | +18% | 115 |
| 43259 Egd us exam duodenum/jejunum | $453 | $384 | +18% | 115 |
Lowest vs national
| Code | Alabama | National | Gap | Prov. |
|---|---|---|---|---|
| 11102 Tangntl bx skin single les | $38 | $65 | -41% | 131 |
| 11104 Punch bx skin single lesion | $48 | $81 | -41% | 131 |
| 11301 Shave skin lesion 0.6-1.0 cm | $51 | $85 | -40% | 131 |
| 99487 Cplx chrnc care 1st 60 min | $74 | $121 | -39% | 102 |
| 11302 Shave skin lesion 1.1-2.0 cm | $60 | $98 | -39% | 131 |
| 99350 Home/res vst est high mdm 60 | $151 | $247 | -39% | 103 |
| 99349 Home/res vst est mod mdm 40 | $107 | $174 | -39% | 103 |
| 17311 Mohs 1 stage h/n/hf/g | $359 | $577 | -38% | 131 |
| 99495 Transj care mgmt mod f2f 14d | $131 | $211 | -38% | 103 |
| 99496 Transj care mgmt high f2f 7d | $181 | $291 | -38% | 103 |
| 99204 Office o/p new mod 45 min | $115 | $183 | -37% | 950 |
| 17313 Mohs 1 stage t/a/l | $322 | $515 | -37% | 131 |
| 99426 Prin care mgmt staff 1st 30 | $49 | $77 | -36% | 116 |
| 99457 Rpm tx mgmt 1st 20 min | $34 | $53 | -36% | 228 |
| 99348 Home/res vst est low mdm 30 | $70 | $109 | -36% | 103 |
Frequently asked questions
How do commercial reimbursement rates in Alabama compare with the rest of the country?
Alabama ranks 44th of 51 states with an index of 87, across 228 procedure codes. Median commercial rates run 128% of the Medicare rate.
Which payer has the highest rates in Alabama?
In the files we analyzed, Aetna has the highest index (100) and Cigna the lowest (86). Each payer's figures describe the specific plans and networks in the files used, not its whole book of business.
Which specialty has the strongest rates in Alabama?
Gastroenterology ranks 29th of 50 states.
How many providers does this Alabama page cover?
953 sampled providers across 4 payers. The data comes from a random sample of providers, so counts describe the sample, not every provider in the state.
Which procedures differ most between Alabama and the national median?
CPT 67036 (Removal of inner eye fluid) is highest relative to the nation at 154% of the national median; CPT 11102 (Tangntl bx skin single les) is lowest at 59%.
Methodology
- Source: in-network negotiated-rate files published under the federal Transparency in Coverage rule, August 2026 snapshot: UnitedHealthcare Choice plans (74 files); Aetna commercial plans (70 files); Cigna national PPO (1 files); BCBS licensees' own-network files (5,387 files). Payer comparisons describe these files, not each payer's entire book of business.
- Sample: rates come from a random sample of up to 150 providers per state and specialty. Counts on this page are sampled providers and TINs, not totals.
- Which providers count: only providers in a specialty relevant to the code, because a rate in a payer file attaches to a provider group and is listed under every provider in that group.
- Filters: fee-for-service, professional billing class, no modifier, negotiated or fee-schedule dollar rates. Rates outside 1% to 1,000% of the Medicare rate are excluded.
- Statistic: one median rate per provider, then percentiles across providers. A cell is shown only with at least 15 sampled providers and 4 TINs.
- Medicare benchmark: CY2026 national physician fee schedule, non-QPP conversion factor, unadjusted for locality. Where the non-facility rate is more than twice the facility rate (office rates that include device or supply cost), the facility rate is used so comparisons are like for like.
Benchmark your Alabama contracts
Compare your negotiated rates with these state medians by payer and specialty.