How much rates vary
Facilitymedian $2,951 · 10th to 90th $759 to $5,754Professionalmedian $1,413 · 10th to 90th $407 to $2,951
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 $309.03 Median $3,090.30 Typical High $14,454.40 | Facility | None | $309.03 | $3,090.30 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | None | $309.03 | $309.03 | $309.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,949.84 Median $3,548.13 Typical High $6,165.95 | Facility | None | $1,949.84 | $3,548.13 | $6,165.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $446.68 Median $1,548.82 Typical High $3,019.95 | Professional | None | $446.68 | $1,548.82 | $3,019.95 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $2,041.74 Typical High $3,467.37 | Facility | None | $758.58 | $2,041.74 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $1,445.44 | Professional | None | $588.84 | $588.84 | $1,445.44 |
DeanCare Setting Facility Modifier None Typical Low $208.93 Median $371.54 Typical High $691.83 | Facility | None | $208.93 | $371.54 | $691.83 |
Medica Setting Facility Modifier None Typical Low $616.60 Median $2,398.83 Typical High $5,623.41 | Facility | None | $616.60 | $2,398.83 | $5,623.41 |
Medica Setting Professional Modifier None Typical Low $562.34 Median $1,479.11 Typical High $2,511.89 | Professional | None | $562.34 | $1,479.11 | $2,511.89 |
Network Health Setting Facility Modifier None Typical Low $1,548.82 Median $2,818.38 Typical High $4,786.30 | Facility | None | $1,548.82 | $2,818.38 | $4,786.30 |
Prevea360 Setting Facility Modifier None Typical Low $208.93 Median $371.54 Typical High $691.83 | Facility | None | $208.93 | $371.54 | $691.83 |
Quartz Setting Professional Modifier None Typical Low $467.74 Median $870.96 Typical High $1,148.15 | Professional | None | $467.74 | $870.96 | $1,148.15 |
Quartz Setting Facility Modifier None Typical Low $758.58 Median $2,041.74 Typical High $3,467.37 | Facility | None | $758.58 | $2,041.74 | $3,467.37 |
Quartz Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $1,445.44 | Professional | None | $588.84 | $588.84 | $1,445.44 |
United Setting Facility Modifier None Typical Low $707.95 Median $2,818.38 Typical High $4,897.79 | Facility | None | $707.95 | $2,818.38 | $4,897.79 |
United Setting Professional Modifier None Typical Low $467.74 Median $1,548.82 Typical High $2,398.83 | Professional | None | $467.74 | $1,548.82 | $2,398.83 |
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 $154.88 Median $154.88 Typical High $154.88 | Professional | 52 · Reduced service | $154.88 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | 53 · Discontinued | $61.66 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | 54 · Surgery only | $234.42 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | 55 · Aftercare only | $46.77 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | 56 · Pre-op care only | $30.90 | $30.90 | $30.90 |
Where Wisconsin sits
The same service costs 8.1 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· 2nd of 51
$1,950
TX $2,291NY $282
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.