How much rates vary
Facilitymedian $676 · 10th to 90th $66 to $6,457Professionalmedian $37 · 10th to 90th $22 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 $52.48 Median $5,128.61 Typical High $15,135.61 | Facility | None | $52.48 | $5,128.61 | $15,135.61 |
Aetna Setting Professional Modifier None Typical Low $21.88 Median $36.31 Typical High $69.18 | Professional | None | $21.88 | $36.31 | $69.18 |
Ambetter Setting Professional Modifier None Typical Low $23.99 Median $38.02 Typical High $40.74 | Professional | None | $23.99 | $38.02 | $40.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $4,786.30 Typical High $9,549.93 | Facility | None | $2,137.96 | $4,786.30 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $22.39 Median $34.67 Typical High $114.82 | Professional | None | $22.39 | $34.67 | $114.82 |
Blue Shield Setting Facility Modifier None Typical Low $93.33 Median $416.87 Typical High $1,479.11 | Facility | None | $93.33 | $416.87 | $1,479.11 |
Blue Shield Setting Professional Modifier None Typical Low $22.39 Median $32.36 Typical High $56.23 | Professional | None | $22.39 | $32.36 | $56.23 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $25.70 Median $46.77 Typical High $63.10 | Professional | None | $25.70 | $46.77 | $63.10 |
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 $23.99 Median $40.74 Typical High $66.07 | Professional | None | $23.99 | $40.74 | $66.07 |
Contra Costa Health Setting Professional Modifier None Typical Low $22.91 Median $33.11 Typical High $61.66 | Professional | None | $22.91 | $33.11 | $61.66 |
HealthNet Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | None | $295.12 | $295.12 | $295.12 |
Kaiser Permanente Setting Professional Modifier None Typical Low $21.38 Median $47.86 Typical High $87.10 | Professional | None | $21.38 | $47.86 | $87.10 |
Lucent Health Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $389.05 | Professional | None | $331.13 | $331.13 | $389.05 |
Molina Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $63.10 | Professional | None | $38.02 | $38.02 | $63.10 |
Providence Setting Facility Modifier None Typical Low $28.18 Median $53.70 Typical High $676.08 | Facility | None | $28.18 | $53.70 | $676.08 |
Providence Setting Professional Modifier None Typical Low $23.99 Median $41.69 Typical High $63.10 | Professional | None | $23.99 | $41.69 | $63.10 |
Sutter Health Plus Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $147.91 | Professional | None | $81.28 | $81.28 | $147.91 |
United Setting Facility Modifier None Typical Low $120.23 Median $489.78 Typical High $3,090.30 | Facility | None | $120.23 | $489.78 | $3,090.30 |
United Setting Professional Modifier None Typical Low $19.95 Median $37.15 Typical High $75.86 | Professional | None | $19.95 | $37.15 | $75.86 |
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 $11.48 Median $11.48 Typical High $20.42 | Facility | 52 · Reduced service | $11.48 | $11.48 | $20.42 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $4.57 Median $4.57 Typical High $8.32 | Facility | 53 · Discontinued | $4.57 | $4.57 | $8.32 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $16.98 Median $17.38 Typical High $30.90 | Facility | 54 · Surgery only | $16.98 | $17.38 | $30.90 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $3.39 Median $3.47 Typical High $6.17 | Facility | 55 · Aftercare only | $3.39 | $3.47 | $6.17 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $2.29 Median $2.29 Typical High $4.17 | Facility | 56 · Pre-op care only | $2.29 | $2.29 | $4.17 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $10.96 Median $16.60 Typical High $19.50 | Professional | 52 · Reduced service | $10.96 | $16.60 | $19.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.37 Median $6.76 Typical High $7.76 | Professional | 53 · Discontinued | $4.37 | $6.76 | $7.76 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $16.22 Median $25.12 Typical High $29.51 | Professional | 54 · Surgery only | $16.22 | $25.12 | $29.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.24 Median $5.01 Typical High $5.89 | Professional | 55 · Aftercare only | $3.24 | $5.01 | $5.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.19 Median $3.39 Typical High $3.89 | Professional | 56 · Pre-op care only | $2.19 | $3.39 | $3.89 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $35.48 Median $37.15 Typical High $38.02 | Professional | 59 · Distinct service | $35.48 | $37.15 | $38.02 |
Ambetter Setting Professional Modifier Q8 · Foot care: two class B findings Typical Low $35.48 Median $37.15 Typical High $37.15 | Professional | Q8 · Foot care: two class B findings | $35.48 | $37.15 | $37.15 |
Ambetter Setting Professional Modifier Q9 · Foot care: one B, two C Typical Low $38.02 Median $42.66 Typical High $42.66 | Professional | Q9 · Foot care: one B, two C | $38.02 | $42.66 | $42.66 |
Where California 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.
California· 48th of 51
$38.90
AK $120NJ $34.67
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.