How much rates vary
Facilitymedian $7,586 · 10th to 90th $1,047 to $14,125Professionalmedian $776 · 10th to 90th $339 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 $302.00 Median $6,456.54 Typical High $14,454.40 | Facility | None | $302.00 | $6,456.54 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $3,235.94 | Professional | None | $302.00 | $302.00 | $3,235.94 |
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 $363.08 Median $812.83 Typical High $1,258.93 | Professional | None | $363.08 | $812.83 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $1,258.93 Typical High $2,089.30 | Facility | None | $758.58 | $1,258.93 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $676.08 Typical High $776.25 | Professional | None | $467.74 | $676.08 | $776.25 |
DeanCare Setting Facility Modifier None Typical Low $467.74 Median $5,623.41 Typical High $10,471.29 | Facility | None | $467.74 | $5,623.41 | $10,471.29 |
DeanCare Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | None | $851.14 | $851.14 | $851.14 |
Medica Setting Facility Modifier None Typical Low $954.99 Median $6,606.93 Typical High $13,803.84 | Facility | None | $954.99 | $6,606.93 | $13,803.84 |
Medica Setting Professional Modifier None Typical Low $426.58 Median $1,202.26 Typical High $2,818.38 | Professional | None | $426.58 | $1,202.26 | $2,818.38 |
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 $549.54 Median $549.54 Typical High $549.54 | Professional | None | $549.54 | $549.54 | $549.54 |
Prevea360 Setting Facility Modifier None Typical Low $234.42 Median $467.74 Typical High $912.01 | Facility | None | $234.42 | $467.74 | $912.01 |
Quartz Setting Professional Modifier None Typical Low $371.54 Median $660.69 Typical High $1,023.29 | Professional | None | $371.54 | $660.69 | $1,023.29 |
Quartz Setting Facility Modifier None Typical Low $645.65 Median $954.99 Typical High $2,691.53 | Facility | None | $645.65 | $954.99 | $2,691.53 |
Quartz Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | None | $831.76 | $831.76 | $831.76 |
Security Health Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,905.46 | $1,905.46 | $1,905.46 |
Security Health Setting Professional Modifier None Typical Low $2,630.27 Median $3,311.31 Typical High $4,073.80 | Professional | None | $2,630.27 | $3,311.31 | $4,073.80 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $7,413.10 Typical High $13,489.63 | Facility | None | $1,479.11 | $7,413.10 | $13,489.63 |
United Setting Professional Modifier None Typical Low $354.81 Median $794.33 Typical High $2,454.71 | Professional | None | $354.81 | $794.33 | $2,454.71 |
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 $151.36 Median $151.36 Typical High $1,584.89 | Professional | 52 · Reduced service | $151.36 | $151.36 | $1,584.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $60.26 Typical High $645.65 | Professional | 53 · Discontinued | $60.26 | $60.26 | $645.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $223.87 Typical High $2,398.83 | Professional | 54 · Surgery only | $223.87 | $223.87 | $2,398.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $44.67 Typical High $478.63 | Professional | 55 · Aftercare only | $44.67 | $44.67 | $478.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $30.20 Typical High $323.59 | Professional | 56 · Pre-op care only | $30.20 | $30.20 | $323.59 |
Where Wisconsin sits
The same service costs 7.8 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· 16th of 51
$1,047
TX $2,399DE $309
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.