How much rates vary
Facilitymedian $282 · 10th to 90th $110 to $2,399Professionalmedian $59 · 10th to 90th $13 to $123
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 $467.74 Median $2,187.76 Typical High $6,918.31 | Facility | None | $467.74 | $2,187.76 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $16.60 Median $58.88 Typical High $97.72 | Professional | None | $16.60 | $58.88 | $97.72 |
Ambetter Setting Professional Modifier None Typical Low $19.50 Median $77.62 Typical High $81.28 | Professional | None | $19.50 | $77.62 | $81.28 |
BCBS Texas Setting Facility Modifier None Typical Low $151.36 Median $288.40 Typical High $1,548.82 | Facility | None | $151.36 | $288.40 | $1,548.82 |
BCBS Texas Setting Professional Modifier None Typical Low $17.78 Median $58.88 Typical High $100.00 | Professional | None | $17.78 | $58.88 | $100.00 |
Christus Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Facility | None | $169.82 | $169.82 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $812.83 | Facility | None | $50.12 | $66.07 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $20.89 Median $53.70 Typical High $95.50 | Professional | None | $20.89 | $53.70 | $95.50 |
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 |
Moda Health Setting Facility Modifier None Typical Low $28.84 Median $630.96 Typical High $4,168.69 | Facility | None | $28.84 | $630.96 | $4,168.69 |
Moda Health Setting Professional Modifier None Typical Low $16.60 Median $58.88 Typical High $109.65 | Professional | None | $16.60 | $58.88 | $109.65 |
Molina Setting Professional Modifier None Typical Low $9.55 Median $53.70 Typical High $72.44 | Professional | None | $9.55 | $53.70 | $72.44 |
Providence Setting Facility Modifier None Typical Low $20.42 Median $66.07 Typical High $151.36 | Facility | None | $20.42 | $66.07 | $151.36 |
Providence Setting Professional Modifier None Typical Low $20.89 Median $53.70 Typical High $97.72 | Professional | None | $20.89 | $53.70 | $97.72 |
United Setting Facility Modifier None Typical Low $141.25 Median $741.31 Typical High $2,187.76 | Facility | None | $141.25 | $741.31 | $2,187.76 |
United Setting Professional Modifier None Typical Low $19.50 Median $46.77 Typical High $83.18 | Professional | None | $19.50 | $46.77 | $83.18 |
Wellpoint Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | None | $81.28 | $81.28 | $81.28 |
11 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 $8.32 Median $30.20 Typical High $39.81 | Professional | 52 · Reduced service | $8.32 | $30.20 | $39.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.39 Median $12.59 Typical High $15.85 | Professional | 53 · Discontinued | $3.39 | $12.59 | $15.85 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $12.59 Median $44.67 Typical High $60.26 | Professional | 54 · Surgery only | $12.59 | $44.67 | $60.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.51 Median $8.91 Typical High $12.02 | Professional | 55 · Aftercare only | $2.51 | $8.91 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.70 Median $6.17 Typical High $7.94 | Professional | 56 · Pre-op care only | $1.70 | $6.17 | $7.94 |
Ambetter Setting Professional Modifier Q9 · Foot care: one B, two C Typical Low $70.79 Median $70.79 Typical High $77.62 | Professional | Q9 · Foot care: one B, two C | $70.79 | $70.79 | $77.62 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $8.32 Median $30.20 Typical High $39.81 | Professional | 52 · Reduced service | $8.32 | $30.20 | $39.81 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $3.39 Median $12.02 Typical High $15.85 | Professional | 53 · Discontinued | $3.39 | $12.02 | $15.85 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $12.59 Median $44.67 Typical High $60.26 | Professional | 54 · Surgery only | $12.59 | $44.67 | $60.26 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $2.51 Median $8.91 Typical High $12.02 | Professional | 55 · Aftercare only | $2.51 | $8.91 | $12.02 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.95 Median $6.46 Typical High $8.13 | Professional | 56 · Pre-op care only | $1.95 | $6.46 | $8.13 |
Where Texas 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.
Texas· 27th of 51
$66.07
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.