How much rates vary
Facilitymedian $1,202 · 10th to 90th $93 to $3,631Professionalmedian $229 · 10th to 90th $89 to $447
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 $61.66 Median $91.20 Typical High $14,454.40 | Facility | None | $61.66 | $91.20 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $91.20 Typical High $512.86 | Professional | None | $61.66 | $91.20 | $512.86 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,174.90 Median $2,754.23 Typical High $4,897.79 | Facility | None | $1,174.90 | $2,754.23 | $4,897.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $107.15 Median $257.04 Typical High $446.68 | Professional | None | $107.15 | $257.04 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $89.13 Median $263.03 Typical High $812.83 | Facility | None | $89.13 | $263.03 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $199.53 Typical High $562.34 | Professional | None | $89.13 | $199.53 | $562.34 |
DeanCare Setting Facility Modifier None Typical Low $61.66 Median $77.62 Typical High $134.90 | Facility | None | $61.66 | $77.62 | $134.90 |
DeanCare Setting Professional Modifier None Typical Low $117.49 Median $173.78 Typical High $229.09 | Professional | None | $117.49 | $173.78 | $229.09 |
Medica Setting Facility Modifier None Typical Low $134.90 Median $812.83 Typical High $1,778.28 | Facility | None | $134.90 | $812.83 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $109.65 Median $346.74 Typical High $501.19 | Professional | None | $109.65 | $346.74 | $501.19 |
Network Health Setting Facility Modifier None Typical Low $831.76 Median $954.99 Typical High $2,344.23 | Facility | None | $831.76 | $954.99 | $2,344.23 |
Network Health Setting Professional Modifier None Typical Low $93.33 Median $141.25 Typical High $251.19 | Professional | None | $93.33 | $141.25 | $251.19 |
Prevea360 Setting Facility Modifier None Typical Low $61.66 Median $77.62 Typical High $134.90 | Facility | None | $61.66 | $77.62 | $134.90 |
Quartz Setting Professional Modifier None Typical Low $104.71 Median $186.21 Typical High $331.13 | Professional | None | $104.71 | $186.21 | $331.13 |
Quartz Setting Facility Modifier None Typical Low $79.43 Median $120.23 Typical High $1,071.52 | Facility | None | $79.43 | $120.23 | $1,071.52 |
Quartz Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | None | $158.49 | $158.49 | $158.49 |
Security Health Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $190.55 | Professional | None | $128.82 | $128.82 | $190.55 |
Security Health Setting Professional Modifier None Typical Low $269.15 Median $371.54 Typical High $524.81 | Professional | None | $269.15 | $371.54 | $524.81 |
United Setting Facility Modifier None Typical Low $218.78 Median $1,148.15 Typical High $1,862.09 | Facility | None | $218.78 | $1,148.15 | $1,862.09 |
United Setting Professional Modifier None Typical Low $81.28 Median $204.17 Typical High $416.87 | Professional | None | $81.28 | $204.17 | $416.87 |
11 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 Facility Modifier 52 · Reduced service Typical Low $30.90 Median $30.90 Typical High $45.71 | Facility | 52 · Reduced service | $30.90 | $30.90 | $45.71 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $12.30 Median $12.30 Typical High $18.20 | Facility | 53 · Discontinued | $12.30 | $12.30 | $18.20 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $45.71 Median $45.71 Typical High $69.18 | Facility | 54 · Surgery only | $45.71 | $45.71 | $69.18 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $9.12 Median $9.12 Typical High $13.80 | Facility | 55 · Aftercare only | $9.12 | $9.12 | $13.80 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.17 Median $6.17 Typical High $9.12 | Facility | 56 · Pre-op care only | $6.17 | $6.17 | $9.12 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $30.90 Median $45.71 Typical High $257.04 | Professional | 52 · Reduced service | $30.90 | $45.71 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $18.20 Typical High $102.33 | Professional | 53 · Discontinued | $12.30 | $18.20 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $45.71 Median $69.18 Typical High $380.19 | Professional | 54 · Surgery only | $45.71 | $69.18 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $13.80 Typical High $75.86 | Professional | 55 · Aftercare only | $9.12 | $13.80 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $9.12 Typical High $51.29 | Professional | 56 · Pre-op care only | $6.17 | $9.12 | $51.29 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $57.54 Median $87.10 Typical High $114.82 | Professional | 51 · Multiple procedures | $57.54 | $87.10 | $114.82 |
Where Wisconsin sits
The same service costs 3.4 times more in Alaska than in Virginia. 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
$263
AK $263VA $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.