How much rates vary
Facilitymedian $6,166 · 10th to 90th $1,202 to $11,220Professionalmedian $1,862 · 10th to 90th $692 to $3,548
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 $724.44 Median $6,456.54 Typical High $14,454.40 | Facility | None | $724.44 | $6,456.54 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | None | $724.44 | $724.44 | $724.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,011.87 Median $7,585.78 Typical High $11,481.54 | Facility | None | $5,011.87 | $7,585.78 | $11,481.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $645.65 Median $2,041.74 Typical High $4,073.80 | Professional | None | $645.65 | $2,041.74 | $4,073.80 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $3,801.89 Typical High $6,456.54 | Facility | None | $758.58 | $3,801.89 | $6,456.54 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $1,737.80 | Professional | None | $691.83 | $691.83 | $1,737.80 |
DeanCare Setting Facility Modifier None Typical Low $302.00 Median $870.96 Typical High $1,621.81 | Facility | None | $302.00 | $870.96 | $1,621.81 |
Medica Setting Facility Modifier None Typical Low $1,096.48 Median $5,623.41 Typical High $10,964.78 | Facility | None | $1,096.48 | $5,623.41 | $10,964.78 |
Medica Setting Professional Modifier None Typical Low $676.08 Median $1,778.28 Typical High $2,951.21 | Professional | None | $676.08 | $1,778.28 | $2,951.21 |
Network Health Setting Facility Modifier None Typical Low $2,818.38 Median $7,762.47 Typical High $9,120.11 | Facility | None | $2,818.38 | $7,762.47 | $9,120.11 |
Prevea360 Setting Facility Modifier None Typical Low $302.00 Median $870.96 Typical High $1,621.81 | Facility | None | $302.00 | $870.96 | $1,621.81 |
Quartz Setting Professional Modifier None Typical Low $912.01 Median $1,737.80 Typical High $2,454.71 | Professional | None | $912.01 | $1,737.80 | $2,454.71 |
Quartz Setting Facility Modifier None Typical Low $758.58 Median $3,801.89 Typical High $6,456.54 | Facility | None | $758.58 | $3,801.89 | $6,456.54 |
Quartz Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $1,737.80 | Professional | None | $691.83 | $691.83 | $1,737.80 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $6,456.54 Typical High $11,481.54 | Facility | None | $1,318.26 | $6,456.54 | $11,481.54 |
United Setting Professional Modifier None Typical Low $691.83 Median $1,819.70 Typical High $2,818.38 | Professional | None | $691.83 | $1,819.70 | $2,818.38 |
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 $363.08 Median $363.08 Typical High $363.08 | Professional | 52 · Reduced service | $363.08 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | 53 · Discontinued | $144.54 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | 54 · Surgery only | $549.54 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | 55 · Aftercare only | $109.65 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | 56 · Pre-op care only | $72.44 | $72.44 | $72.44 |
Where Wisconsin sits
The same service costs 10.2 times more in Texas than in New York. 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· 5th of 51
$2,630
TX $4,074NY $398
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.