How much rates vary
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 $25.70 Median $43.65 Typical High $60.26 | Facility | None | $25.70 | $43.65 | $60.26 |
Aetna Setting Professional Modifier None Typical Low $23.44 Median $39.81 Typical High $53.70 | Professional | None | $23.44 | $39.81 | $53.70 |
CareSource Setting Professional Modifier None Typical Low $27.54 Median $40.74 Typical High $48.98 | Professional | None | $27.54 | $40.74 | $48.98 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $38.90 | Facility | None | $34.67 | $34.67 | $38.90 |
Cigna Setting Professional Modifier None Typical Low $24.55 Median $43.65 Typical High $117.49 | Professional | None | $24.55 | $43.65 | $117.49 |
Highmark BCBS Setting Facility Modifier None Typical Low $58.88 Median $162.18 Typical High $245.47 | Facility | None | $58.88 | $162.18 | $245.47 |
United Setting Facility Modifier None Typical Low $100.00 Median $131.83 Typical High $457.09 | Facility | None | $100.00 | $131.83 | $457.09 |
United Setting Professional Modifier None Typical Low $24.55 Median $42.66 Typical High $100.00 | Professional | None | $24.55 | $42.66 | $100.00 |
6 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 $10.47 Median $11.48 Typical High $20.42 | Professional | 52 · Reduced service | $10.47 | $11.48 | $20.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.17 Median $4.68 Typical High $8.13 | Professional | 53 · Discontinued | $4.17 | $4.68 | $8.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $15.85 Median $17.38 Typical High $30.20 | Professional | 54 · Surgery only | $15.85 | $17.38 | $30.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.16 Median $3.47 Typical High $6.03 | Professional | 55 · Aftercare only | $3.16 | $3.47 | $6.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.09 Median $2.29 Typical High $4.07 | Professional | 56 · Pre-op care only | $2.09 | $2.29 | $4.07 |
Highmark BCBS Setting Professional Modifier Q7 · Foot care: one class A finding + Q8 · Foot care: two class B findings + Q9 · Foot care: one B, two C Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | Q7 · Foot care: one class A finding + Q8 · Foot care: two class B findings + Q9 · Foot care: one B, two C | $64.57 | $64.57 | $64.57 |
Where West Virginia 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.
West Virginia· 32nd of 51
$43.65
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.