How much rates vary
Facilitymedian $123 · 10th to 90th $52 to $2,512Professionalmedian $40 · 10th to 90th $14 to $83
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 $426.58 Median $2,187.76 Typical High $6,760.83 | Facility | None | $426.58 | $2,187.76 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $16.98 Median $32.36 Typical High $45.71 | Professional | None | $16.98 | $32.36 | $45.71 |
Ambetter Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $41.69 | Professional | None | $37.15 | $37.15 | $41.69 |
BCBS Texas Setting Facility Modifier None Typical Low $54.95 Median $91.20 Typical High $251.19 | Facility | None | $54.95 | $91.20 | $251.19 |
BCBS Texas Setting Professional Modifier None Typical Low $19.50 Median $36.31 Typical High $66.07 | Professional | None | $19.50 | $36.31 | $66.07 |
Christus Setting Facility Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Facility | None | $52.48 | $52.48 | $52.48 |
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 $22.39 Median $41.69 Typical High $60.26 | Professional | None | $22.39 | $41.69 | $60.26 |
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 |
Moda Health Setting Facility Modifier None Typical Low $26.92 Median $630.96 Typical High $4,168.69 | Facility | None | $26.92 | $630.96 | $4,168.69 |
Moda Health Setting Professional Modifier None Typical Low $16.98 Median $32.36 Typical High $48.98 | Professional | None | $16.98 | $32.36 | $48.98 |
Molina Setting Professional Modifier None Typical Low $9.77 Median $53.70 Typical High $74.13 | Professional | None | $9.77 | $53.70 | $74.13 |
Oscar Health Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Facility | None | $363.08 | $363.08 | $363.08 |
Providence Setting Facility Modifier None Typical Low $21.88 Median $50.12 Typical High $151.36 | Facility | None | $21.88 | $50.12 | $151.36 |
Providence Setting Professional Modifier None Typical Low $22.39 Median $40.74 Typical High $60.26 | Professional | None | $22.39 | $40.74 | $60.26 |
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 $20.89 Median $35.48 Typical High $56.23 | Professional | None | $20.89 | $35.48 | $56.23 |
Wellpoint Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | None | $44.67 | $44.67 | $44.67 |
15 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 $8.51 Median $15.85 Typical High $19.05 | Professional | 52 · Reduced service | $8.51 | $15.85 | $19.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.47 Median $6.31 Typical High $7.59 | Professional | 53 · Discontinued | $3.47 | $6.31 | $7.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $12.88 Median $23.44 Typical High $28.84 | Professional | 54 · Surgery only | $12.88 | $23.44 | $28.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.57 Median $4.79 Typical High $5.75 | Professional | 55 · Aftercare only | $2.57 | $4.79 | $5.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.70 Median $3.16 Typical High $3.80 | Professional | 56 · Pre-op care only | $1.70 | $3.16 | $3.80 |
Ambetter Setting Professional Modifier Q7 · Foot care: one class A finding Typical Low $41.69 Median $45.71 Typical High $45.71 | Professional | Q7 · Foot care: one class A finding | $41.69 | $45.71 | $45.71 |
Ambetter Setting Professional Modifier Q8 · Foot care: two class B findings Typical Low $19.95 Median $43.65 Typical High $45.71 | Professional | Q8 · Foot care: two class B findings | $19.95 | $43.65 | $45.71 |
Ambetter Setting Professional Modifier Q9 · Foot care: one B, two C Typical Low $19.05 Median $19.05 Typical High $43.65 | Professional | Q9 · Foot care: one B, two C | $19.05 | $19.05 | $43.65 |
Moda Health Setting Facility Modifier Q8 · Foot care: two class B findings Typical Low $36.31 Median $58.88 Typical High $194.98 | Facility | Q8 · Foot care: two class B findings | $36.31 | $58.88 | $194.98 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $8.51 Median $16.22 Typical High $18.62 | Professional | 52 · Reduced service | $8.51 | $16.22 | $18.62 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $3.47 Median $6.46 Typical High $7.59 | Professional | 53 · Discontinued | $3.47 | $6.46 | $7.59 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $12.88 Median $23.99 Typical High $28.18 | Professional | 54 · Surgery only | $12.88 | $23.99 | $28.18 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $2.57 Median $4.79 Typical High $5.62 | Professional | 55 · Aftercare only | $2.57 | $4.79 | $5.62 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.70 Median $3.16 Typical High $3.80 | Professional | 56 · Pre-op care only | $1.70 | $3.16 | $3.80 |
Moda Health Setting Professional Modifier 59 · Distinct service Typical Low $9.77 Median $40.74 Typical High $81.28 | Professional | 59 · Distinct service | $9.77 | $40.74 | $81.28 |
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· 27th of 51
$44.67
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.