How much rates vary
Facilitymedian $129 · 10th to 90th $52 to $2,630Professionalmedian $27 · 10th to 90th $7 to $56
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 $10.23 Median $23.44 Typical High $33.11 | Professional | None | $10.23 | $23.44 | $33.11 |
Ambetter Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | None | $31.62 | $31.62 | $31.62 |
BCBS Texas Setting Facility Modifier None Typical Low $52.48 Median $97.72 Typical High $323.59 | Facility | None | $52.48 | $97.72 | $323.59 |
BCBS Texas Setting Professional Modifier None Typical Low $11.75 Median $26.92 Typical High $48.98 | Professional | None | $11.75 | $26.92 | $48.98 |
Christus Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Facility | None | $57.54 | $57.54 | $57.54 |
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 $13.80 Median $28.18 Typical High $43.65 | Professional | None | $13.80 | $28.18 | $43.65 |
Lucent Health Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $281.84 | Professional | None | $239.88 | $239.88 | $281.84 |
Moda Health Setting Facility Modifier None Typical Low $16.98 Median $575.44 Typical High $4,168.69 | Facility | None | $16.98 | $575.44 | $4,168.69 |
Moda Health Setting Professional Modifier None Typical Low $10.23 Median $23.44 Typical High $36.31 | Professional | None | $10.23 | $23.44 | $36.31 |
Molina Setting Professional Modifier None Typical Low $4.79 Median $26.30 Typical High $36.31 | Professional | None | $4.79 | $26.30 | $36.31 |
Providence Setting Facility Modifier None Typical Low $13.18 Median $41.69 Typical High $151.36 | Facility | None | $13.18 | $41.69 | $151.36 |
Providence Setting Professional Modifier None Typical Low $13.80 Median $27.54 Typical High $43.65 | Professional | None | $13.80 | $27.54 | $43.65 |
United Setting Facility Modifier None Typical Low $138.04 Median $741.31 Typical High $2,187.76 | Facility | None | $138.04 | $741.31 | $2,187.76 |
United Setting Professional Modifier None Typical Low $12.30 Median $25.12 Typical High $39.81 | Professional | None | $12.30 | $25.12 | $39.81 |
Wellpoint Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | None | $32.36 | $32.36 | $32.36 |
12 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 $5.13 Median $11.22 Typical High $13.80 | Professional | 52 · Reduced service | $5.13 | $11.22 | $13.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.04 Median $4.68 Typical High $5.62 | Professional | 53 · Discontinued | $2.04 | $4.68 | $5.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $7.76 Median $16.98 Typical High $20.89 | Professional | 54 · Surgery only | $7.76 | $16.98 | $20.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.55 Median $3.47 Typical High $4.17 | Professional | 55 · Aftercare only | $1.55 | $3.47 | $4.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.02 Median $2.24 Typical High $2.82 | Professional | 56 · Pre-op care only | $1.02 | $2.24 | $2.82 |
Ambetter Setting Professional Modifier Q7 · Foot care: one class A finding Typical Low $12.59 Median $30.20 Typical High $30.20 | Professional | Q7 · Foot care: one class A finding | $12.59 | $30.20 | $30.20 |
Ambetter Setting Professional Modifier Q8 · Foot care: two class B findings Typical Low $28.84 Median $28.84 Typical High $31.62 | Professional | Q8 · Foot care: two class B findings | $28.84 | $28.84 | $31.62 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $5.13 Median $11.48 Typical High $13.80 | Professional | 52 · Reduced service | $5.13 | $11.48 | $13.80 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $2.09 Median $4.68 Typical High $5.50 | Professional | 53 · Discontinued | $2.09 | $4.68 | $5.50 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $7.76 Median $17.38 Typical High $20.89 | Professional | 54 · Surgery only | $7.76 | $17.38 | $20.89 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1.55 Median $3.47 Typical High $4.17 | Professional | 55 · Aftercare only | $1.55 | $3.47 | $4.17 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.02 Median $2.34 Typical High $2.75 | Professional | 56 · Pre-op care only | $1.02 | $2.34 | $2.75 |
Where Texas sits
The same service costs 3.5 times more in Alaska than in New Jersey. 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· 38th of 51
$30.20
AK $83.18NJ $23.99
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.