How much rates vary
Facilitymedian $355 · 10th to 90th $50 to $4,074Professionalmedian $59 · 10th to 90th $19 to $110
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 $77.62 Median $2,137.96 Typical High $7,943.28 | Facility | None | $77.62 | $2,137.96 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $19.50 Median $51.29 Typical High $89.13 | Professional | None | $19.50 | $51.29 | $89.13 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $9.77 Median $22.91 Typical High $38.90 | Professional | 52 · Reduced service | $9.77 | $22.91 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.89 Median $9.33 Typical High $15.49 | Professional | 53 · Discontinued | $3.89 | $9.33 | $15.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $14.45 Median $34.67 Typical High $57.54 | Professional | 54 · Surgery only | $14.45 | $34.67 | $57.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.95 Median $6.92 Typical High $11.48 | Professional | 55 · Aftercare only | $2.95 | $6.92 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.95 Median $4.90 Typical High $7.76 | Professional | 56 · Pre-op care only | $1.95 | $4.90 | $7.76 |
AmeriHealth Setting Professional Modifier None Typical Low $37.15 Median $60.26 Typical High $95.50 | Professional | None | $37.15 | $60.26 | $95.50 |
Capital Blue Cross Setting Facility Modifier None Typical Low $1,202.26 Median $1,412.54 Typical High $56,234.13 | Facility | None | $1,202.26 | $1,412.54 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $79.43 Median $81.28 Typical High $134.90 | Professional | None | $79.43 | $81.28 | $134.90 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $389.05 | Facility | None | $50.12 | $66.07 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $20.42 Median $53.70 Typical High $95.50 | Professional | None | $20.42 | $53.70 | $95.50 |
Emblem Health Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None | $138.04 | $138.04 | $138.04 |
Geisinger Setting Professional Modifier None Typical Low $42.66 Median $87.10 Typical High $134.90 | Professional | None | $42.66 | $87.10 | $134.90 |
Highmark BCBS Setting Facility Modifier None Typical Low $134.90 Median $691.83 Typical High $5,754.40 | Facility | None | $134.90 | $691.83 | $5,754.40 |
Independence Blue Cross Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $74.13 | Professional | None | $37.15 | $37.15 | $74.13 |
Martin's Point Setting Facility Modifier None Typical Low $77.62 Median $1,995.26 Typical High $7,244.36 | Facility | None | $77.62 | $1,995.26 | $7,244.36 |
Martin's Point Setting Professional Modifier None Typical Low $19.50 Median $51.29 Typical High $87.10 | Professional | None | $19.50 | $51.29 | $87.10 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $9.77 Median $22.91 Typical High $38.90 | Professional | 52 · Reduced service | $9.77 | $22.91 | $38.90 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $3.89 Median $10.23 Typical High $15.49 | Professional | 53 · Discontinued | $3.89 | $10.23 | $15.49 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $14.45 Median $34.67 Typical High $57.54 | Professional | 54 · Surgery only | $14.45 | $34.67 | $57.54 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $2.95 Median $6.92 Typical High $11.48 | Professional | 55 · Aftercare only | $2.95 | $6.92 | $11.48 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $1.95 Median $5.13 Typical High $7.76 | Professional | 56 · Pre-op care only | $1.95 | $5.13 | $7.76 |
Oscar Health Setting Professional Modifier None Typical Low $5.01 Median $36.31 Typical High $117.49 | Professional | None | $5.01 | $36.31 | $117.49 |
UPMC Health Plan Setting Facility Modifier None Typical Low $32.36 Median $199.53 Typical High $436.52 | Facility | None | $32.36 | $199.53 | $436.52 |
UPMC Health Plan Setting Professional Modifier None Typical Low $21.88 Median $43.65 Typical High $79.43 | Professional | None | $21.88 | $43.65 | $79.43 |
United Setting Facility Modifier None Typical Low $77.62 Median $158.49 Typical High $1,230.27 | Facility | None | $77.62 | $158.49 | $1,230.27 |
United Setting Professional Modifier None Typical Low $21.38 Median $48.98 Typical High $102.33 | Professional | None | $21.38 | $48.98 | $102.33 |
1 more rate 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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier Q8 · Foot care: two class B findings + Q9 · Foot care: one B, two C Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | Q8 · Foot care: two class B findings + Q9 · Foot care: one B, two C | $75.86 | $75.86 | $75.86 |
Where Pennsylvania 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.
Pennsylvania· 24th of 51
$67.61
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.