How much rates vary
Facilitymedian $417 · 10th to 90th $50 to $4,365Professionalmedian $49 · 10th to 90th $24 to $191
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 $69.18 Median $5,011.87 Typical High $15,135.61 | Facility | None | $69.18 | $5,011.87 | $15,135.61 |
Aetna Setting Professional Modifier None Typical Low $23.99 Median $50.12 Typical High $107.15 | Professional | None | $23.99 | $50.12 | $107.15 |
Ambetter Setting Professional Modifier None Typical Low $64.57 Median $74.13 Typical High $83.18 | Professional | None | $64.57 | $74.13 | $83.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $24.55 Median $32.36 Typical High $3,890.45 | Facility | None | $24.55 | $32.36 | $3,890.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $25.12 Median $46.77 Typical High $151.36 | Professional | None | $25.12 | $46.77 | $151.36 |
Blue Shield Setting Facility Modifier None Typical Low $95.50 Median $416.87 Typical High $1,479.11 | Facility | None | $95.50 | $416.87 | $1,479.11 |
Blue Shield Setting Professional Modifier None Typical Low $23.99 Median $37.15 Typical High $66.07 | Professional | None | $23.99 | $37.15 | $66.07 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $23.99 Median $42.66 Typical High $120.23 | Professional | None | $23.99 | $42.66 | $120.23 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $61.66 Typical High $676.08 | Facility | None | $50.12 | $61.66 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $22.39 Median $51.29 Typical High $97.72 | Professional | None | $22.39 | $51.29 | $97.72 |
Contra Costa Health Setting Professional Modifier None Typical Low $21.38 Median $25.70 Typical High $117.49 | Professional | None | $21.38 | $25.70 | $117.49 |
Kaiser Permanente Setting Professional Modifier None Typical Low $19.95 Median $81.28 Typical High $162.18 | Professional | None | $19.95 | $81.28 | $162.18 |
Lucent Health Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $691.83 | Professional | None | $588.84 | $588.84 | $691.83 |
Molina Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $112.20 | Professional | None | $67.61 | $67.61 | $112.20 |
Providence Setting Facility Modifier None Typical Low $26.92 Median $58.88 Typical High $676.08 | Facility | None | $26.92 | $58.88 | $676.08 |
Providence Setting Professional Modifier None Typical Low $22.39 Median $51.29 Typical High $97.72 | Professional | None | $22.39 | $51.29 | $97.72 |
Sutter Health Plus Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $245.47 | Professional | None | $75.86 | $75.86 | $245.47 |
United Setting Facility Modifier None Typical Low $123.03 Median $489.78 Typical High $3,090.30 | Facility | None | $123.03 | $489.78 | $3,090.30 |
United Setting Professional Modifier None Typical Low $18.20 Median $54.95 Typical High $128.82 | Professional | None | $18.20 | $54.95 | $128.82 |
13 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 52 · Reduced service Typical Low $12.88 Median $13.18 Typical High $30.20 | Facility | 52 · Reduced service | $12.88 | $13.18 | $30.20 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $5.13 Median $5.37 Typical High $12.02 | Facility | 53 · Discontinued | $5.13 | $5.37 | $12.02 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $19.05 Median $19.95 Typical High $44.67 | Facility | 54 · Surgery only | $19.05 | $19.95 | $44.67 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $3.80 Median $3.98 Typical High $8.91 | Facility | 55 · Aftercare only | $3.80 | $3.98 | $8.91 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $2.57 Median $2.63 Typical High $6.03 | Facility | 56 · Pre-op care only | $2.57 | $2.63 | $6.03 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $12.30 Median $21.88 Typical High $30.20 | Professional | 52 · Reduced service | $12.30 | $21.88 | $30.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.90 Median $8.71 Typical High $12.02 | Professional | 53 · Discontinued | $4.90 | $8.71 | $12.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $18.62 Median $33.11 Typical High $44.67 | Professional | 54 · Surgery only | $18.62 | $33.11 | $44.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.72 Median $6.61 Typical High $8.91 | Professional | 55 · Aftercare only | $3.72 | $6.61 | $8.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $4.37 Typical High $6.03 | Professional | 56 · Pre-op care only | $2.45 | $4.37 | $6.03 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | 59 · Distinct service | $69.18 | $69.18 | $69.18 |
Ambetter Setting Professional Modifier Q8 · Foot care: two class B findings Typical Low $37.15 Median $74.13 Typical High $74.13 | Professional | Q8 · Foot care: two class B findings | $37.15 | $74.13 | $74.13 |
Ambetter Setting Professional Modifier Q9 · Foot care: one B, two C Typical Low $69.18 Median $83.18 Typical High $83.18 | Professional | Q9 · Foot care: one B, two C | $69.18 | $83.18 | $83.18 |
Where California 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.
California· 45th of 51
$51.29
WI $123KY $36.31
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.