How much rates vary
Facilitymedian $7,762 · 10th to 90th $1,413 to $14,454Professionalmedian $2,239 · 10th to 90th $741 to $5,754
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 $707.95 Median $6,456.54 Typical High $14,454.40 | Facility | None | $707.95 | $6,456.54 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $3,311.31 | Professional | None | $707.95 | $707.95 | $3,311.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,309.57 Median $10,000.00 Typical High $16,982.44 | Facility | None | $6,309.57 | $10,000.00 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $758.58 Median $2,630.27 Typical High $5,623.41 | Professional | None | $758.58 | $2,630.27 | $5,623.41 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $2,951.21 Typical High $10,232.93 | Facility | None | $954.99 | $2,951.21 | $10,232.93 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,348.96 Typical High $1,548.82 | Professional | None | $933.25 | $1,348.96 | $1,548.82 |
DeanCare Setting Facility Modifier None Typical Low $794.33 Median $5,623.41 Typical High $10,471.29 | Facility | None | $794.33 | $5,623.41 | $10,471.29 |
DeanCare Setting Professional Modifier None Typical Low $1,698.24 Median $2,137.96 Typical High $2,754.23 | Professional | None | $1,698.24 | $2,137.96 | $2,754.23 |
Medica Setting Facility Modifier None Typical Low $954.99 Median $6,606.93 Typical High $15,848.93 | Facility | None | $954.99 | $6,606.93 | $15,848.93 |
Medica Setting Professional Modifier None Typical Low $794.33 Median $2,398.83 Typical High $5,754.40 | Professional | None | $794.33 | $2,398.83 | $5,754.40 |
Network Health Setting Facility Modifier None Typical Low $4,073.80 Median $9,549.93 Typical High $15,848.93 | Facility | None | $4,073.80 | $9,549.93 | $15,848.93 |
Network Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | None | $1,096.48 | $1,096.48 | $1,096.48 |
Prevea360 Setting Facility Modifier None Typical Low $478.63 Median $794.33 Typical High $1,819.70 | Facility | None | $478.63 | $794.33 | $1,819.70 |
Quartz Setting Professional Modifier None Typical Low $891.25 Median $1,548.82 Typical High $2,344.23 | Professional | None | $891.25 | $1,548.82 | $2,344.23 |
Quartz Setting Facility Modifier None Typical Low $758.58 Median $6,760.83 Typical High $10,964.78 | Facility | None | $758.58 | $6,760.83 | $10,964.78 |
Quartz Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,288.25 | $1,288.25 | $1,288.25 |
Security Health Setting Professional Modifier None Typical Low $3,890.45 Median $3,890.45 Typical High $3,890.45 | Professional | None | $3,890.45 | $3,890.45 | $3,890.45 |
Security Health Setting Professional Modifier None Typical Low $4,265.80 Median $6,606.93 Typical High $8,128.31 | Professional | None | $4,265.80 | $6,606.93 | $8,128.31 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $7,585.78 Typical High $13,489.63 | Facility | None | $1,479.11 | $7,585.78 | $13,489.63 |
United Setting Professional Modifier None Typical Low $794.33 Median $1,621.81 Typical High $3,548.13 | Professional | None | $794.33 | $1,621.81 | $3,548.13 |
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 $354.81 Median $354.81 Typical High $1,659.59 | Professional | 52 · Reduced service | $354.81 | $354.81 | $1,659.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $141.25 Typical High $660.69 | Professional | 53 · Discontinued | $141.25 | $141.25 | $660.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $524.81 Typical High $2,454.71 | Professional | 54 · Surgery only | $524.81 | $524.81 | $2,454.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $104.71 Typical High $489.78 | Professional | 55 · Aftercare only | $104.71 | $104.71 | $489.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $70.79 Typical High $331.13 | Professional | 56 · Pre-op care only | $70.79 | $70.79 | $331.13 |
Where Wisconsin sits
The same service costs 5.1 times more in Texas than in Delaware. 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· 4th of 51
$3,090
TX $3,981DE $776
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.