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 $489.78 Median $933.25 Typical High $1,862.09 | Facility | None | $489.78 | $933.25 | $1,862.09 |
Aetna Setting Professional Modifier None Typical Low $21.88 Median $50.12 Typical High $75.86 | Professional | None | $21.88 | $50.12 | $75.86 |
BCBS Alabama Setting Facility Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Facility | None | $239.88 | $239.88 | $239.88 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 Typical Low $13.18 Median $18.20 Typical High $31.62 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 | $13.18 | $18.20 | $31.62 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $102.33 Typical High $512.86 | Facility | None | $50.12 | $102.33 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $22.39 Median $43.65 Typical High $53.70 | Professional | None | $22.39 | $43.65 | $53.70 |
United Setting Facility Modifier None Typical Low $100.00 Median $363.08 Typical High $1,380.38 | Facility | None | $100.00 | $363.08 | $1,380.38 |
United Setting Professional Modifier None Typical Low $19.50 Median $48.98 Typical High $69.18 | Professional | None | $19.50 | $48.98 | $69.18 |
6 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 $10.96 Median $21.38 Typical High $38.02 | Professional | 52 · Reduced service | $10.96 | $21.38 | $38.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.37 Median $8.71 Typical High $15.14 | Professional | 53 · Discontinued | $4.37 | $8.71 | $15.14 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $16.22 Median $32.36 Typical High $56.23 | Professional | 54 · Surgery only | $16.22 | $32.36 | $56.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.24 Median $6.46 Typical High $11.22 | Professional | 55 · Aftercare only | $3.24 | $6.46 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.19 Median $4.37 Typical High $7.59 | Professional | 56 · Pre-op care only | $2.19 | $4.37 | $7.59 |
Ambetter Setting Professional Modifier 59 · Distinct service + Q8 · Foot care: two class B findings Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | 59 · Distinct service + Q8 · Foot care: two class B findings | $66.07 | $66.07 | $66.07 |
Where Alabama sits
The same service costs 3.4 times more in Wisconsin 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· 40th of 51
$58.88
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.