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 $977.24 Median $3,715.35 Typical High $5,623.41 | Facility | None | $977.24 | $3,715.35 | $5,623.41 |
Aetna Setting Professional Modifier None Typical Low $19.05 Median $50.12 Typical High $77.62 | Professional | None | $19.05 | $50.12 | $77.62 |
Ambetter Setting Professional Modifier None Typical Low $70.79 Median $81.28 Typical High $81.28 | Professional | None | $70.79 | $81.28 | $81.28 |
BCBS Arizona Setting Facility Modifier None Typical Low $43.65 Median $104.71 Typical High $275.42 | Facility | None | $43.65 | $104.71 | $275.42 |
BCBS Arizona Setting Professional Modifier None Typical Low $16.60 Median $51.29 Typical High $77.62 | Professional | None | $16.60 | $51.29 | $77.62 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $66.07 Typical High $501.19 | Facility | None | $56.23 | $66.07 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $19.95 Median $45.71 Typical High $77.62 | Professional | None | $19.95 | $45.71 | $77.62 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $316.23 Typical High $1,584.89 | Facility | None | $54.95 | $316.23 | $1,584.89 |
Medica Setting Professional Modifier None Typical Low $51.29 Median $309.03 Typical High $616.60 | Professional | None | $51.29 | $309.03 | $616.60 |
United Setting Facility Modifier None Typical Low $177.83 Median $524.81 Typical High $2,238.72 | Facility | None | $177.83 | $524.81 | $2,238.72 |
United Setting Professional Modifier None Typical Low $20.89 Median $43.65 Typical High $75.86 | Professional | None | $20.89 | $43.65 | $75.86 |
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 $9.55 Median $17.38 Typical High $35.48 | Professional | 52 · Reduced service | $9.55 | $17.38 | $35.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.80 Median $6.92 Typical High $14.13 | Professional | 53 · Discontinued | $3.80 | $6.92 | $14.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $14.45 Median $25.70 Typical High $52.48 | Professional | 54 · Surgery only | $14.45 | $25.70 | $52.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.88 Median $5.13 Typical High $10.47 | Professional | 55 · Aftercare only | $2.88 | $5.13 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.91 Median $3.47 Typical High $7.08 | Professional | 56 · Pre-op care only | $1.91 | $3.47 | $7.08 |
Ambetter Setting Professional Modifier Q9 · Foot care: one B, two C Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | Q9 · Foot care: one B, two C | $70.79 | $70.79 | $70.79 |
Where Arizona 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.
Arizona· 22nd of 51
$69.18
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.