How much rates vary
Facilitymedian $14,454 · 10th to 90th $1,349 to $21,380Professionalmedian $339 · 10th to 90th $81 to $2,188
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 $338.84 Median $8,317.64 Typical High $14,454.40 | Facility | None | $338.84 | $8,317.64 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | None | $338.84 | $338.84 | $338.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $12,022.64 Median $16,982.44 Typical High $23,988.33 | Facility | None | $12,022.64 | $16,982.44 | $23,988.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $134.90 Median $446.68 Typical High $2,570.40 | Professional | None | $134.90 | $446.68 | $2,570.40 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $12,022.64 Typical High $19,498.45 | Facility | None | $758.58 | $12,022.64 | $19,498.45 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $204.17 | Professional | None | $67.61 | $67.61 | $204.17 |
DeanCare Setting Facility Modifier None Typical Low $218.78 Median $398.11 Typical High $741.31 | Facility | None | $218.78 | $398.11 | $741.31 |
Medica Setting Facility Modifier None Typical Low $1,348.96 Median $9,120.11 Typical High $19,952.62 | Facility | None | $1,348.96 | $9,120.11 | $19,952.62 |
Medica Setting Professional Modifier None Typical Low $66.07 Median $173.78 Typical High $281.84 | Professional | None | $66.07 | $173.78 | $281.84 |
Network Health Setting Facility Modifier None Typical Low $3,388.44 Median $12,882.50 Typical High $27,542.29 | Facility | None | $3,388.44 | $12,882.50 | $27,542.29 |
Prevea360 Setting Facility Modifier None Typical Low $218.78 Median $398.11 Typical High $741.31 | Facility | None | $218.78 | $398.11 | $741.31 |
Quartz Setting Professional Modifier None Typical Low $131.83 Median $794.33 Typical High $1,148.15 | Professional | None | $131.83 | $794.33 | $1,148.15 |
Quartz Setting Facility Modifier None Typical Low $758.58 Median $12,022.64 Typical High $19,498.45 | Facility | None | $758.58 | $12,022.64 | $19,498.45 |
Quartz Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $204.17 | Professional | None | $67.61 | $67.61 | $204.17 |
United Setting Facility Modifier None Typical Low $2,041.74 Median $10,715.19 Typical High $20,417.38 | Facility | None | $2,041.74 | $10,715.19 | $20,417.38 |
United Setting Professional Modifier None Typical Low $69.18 Median $204.17 Typical High $346.74 | Professional | None | $69.18 | $204.17 | $346.74 |
5 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 $165.96 Median $165.96 Typical High $165.96 | Professional | 52 · Reduced service | $165.96 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | 53 · Discontinued | $67.61 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | 54 · Surgery only | $251.19 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | 55 · Aftercare only | $50.12 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | 56 · Pre-op care only | $33.88 | $33.88 | $33.88 |
Where Wisconsin sits
The same service costs 93.3 times more in Oregon than in Vermont. 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.
Wisconsin· 25th of 51
$1,047
OR $7,244VT $77.62
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.